The Arizona Senate approved SB 1441 on Wednesday, which would allow patients to challenge an unexpected medical bill after an emergency room visit, according to the Arizona Daily Sun.
Under current Arizona law, patients do not have any type of support to fight insurance companies that refuse to pay for procedures or services a patient received from out-of-network physicians.
SB 1441, authored by Sen. Debbie Lesko (R-Peoria), would allow patients to ask the Arizona Department of Insurance to intervene in cases where patients feel they are being unfairly charged, according to the report.
State intervention, however, would only be available in cases where patients could not check prior to the procedure whether a physician was in or out-of-network.
Arbitration will be available if a healthcare provider does not disclose upfront whether it is considered in-network, charges more than the estimated total cost and does not give the patient a chance to waive their rights to dispute the bill, according to the report.
Sen. Lesko said under SB 1441, patients would only be responsible for the normal co-pay amount and the deductible, in most situations. If the patient agrees ahead of time to a specific out-of-network cost, the legislation will not be applicable, according to the report. However, if the medical bill ends up being more than the agreed upon amount, the patient will have access to the procedure outlined in the legislation.
The Department of Insurance will have until 2019 to create the procedure for the review process if the legislation passes.
Eric Walters Insurance Services
Scottsdale, Az 85260