Nevada proposal could curtail surprise medical bills

CARSON CITY — No one loved a bill heard in committee Wednesday that would keep emergency room patients from getting socked with surprise medical bills from an out-of-network provider that treats them.

But no one hated the bill enough to oppose it.

And nearly all — including health care providers, insurers and patient advocates — said they could grudgingly live with compromises in the bill in the name of making progress on an issue that has long burdened patients and resisted solutions.

“If everybody is moderately annoyed by it, it probably is a good thing,” said Assembly Speaker Jason Frierson, D-Las Vegas, in presenting Assembly Bill 469 to the Assembly Health and Human Services committee. “What we have done is come up with a structure that doesn’t make any stakeholder completely happy but does protect patients, and that was what we set out to do.”

The bill, the product of long discussion and negotiation among stakeholders, would bar an out-of-network provider treating an ER patient with “medically necessary emergency services” from charging more than the patient’s insurance co-payment, co-insurance or deductible. It also establishes procedures for insurers and third-party providers to work out payments between them, without putting the patient in the middle, and for transferring patients from an out-of-network facility where they were initially treated to one within their network within 24 hours of becoming stable.

The bill faces some additional technical amendments and may get other tweaks, including a provision that data on claims processed under the law be collected and an annual report issued.

Speakers called the bill “not perfect,” said they supported it “reluctantly,” or even with “moderate annoyance,” in Frierson’s words, but said it succeeds in protecting patients, physicians, and both sides of the payer-payee health care market.

“As other speakers have indicated, this bill is not ideal, but it’s a start,” said Joanna Jacob, representing Physicians for Fair Coverage, a group seeking to eliminate the coverage gaps that the bill addresses. “I do believe that we are the closest we have ever been to a solution on this thing, and that’s a very important place to be.”

Contact Bill Dentzer at bdentzer@reviewjournal.com or 775-461-0661. Follow @DentzerNews on Twitter.