CONSUMER ALERT: Surprise Medical Bills Ban Begins Today

OSPIRG

OSPIRG is releasing this consumer alert to notify Oregonians about a new law that will protect patients from receiving big surprise out-of-network bills when they receive services at a health care facility that is in their health plan’s network. The new law, established by House Bill 2339 in 2017 with OSPIRG’s strong support, goes into full effect today.

“As of today, Oregon consumers can breathe a little easier when they visit the hospital or emergency room,” said Jesse Ellis O’Brien, OSPIRG Policy Director. “Oregonians no longer have to stomach an unjust and unacceptable status quo, where consumers often had no recourse when they received a giant bill they could do nothing to avoid.”

Before today, Oregon consumers received surprise medical bills in a variety of situations, but one far-too-common scenario occurred when patients received treatment from a physician or other health care provider who does not participate in their health plan—often without the patient’s knowledge or consent—even though the patient sought care at an in-network facility. This led to situations where patients who had done all that can reasonably be expected to access in-network services are stuck with surprise out-of-network bills, which can sometimes be extraordinarily large.

As of today, health care providers are no longer allowed to bill patients directly in these situations for any more than the normal in-network rate, taking the consumer out of the middle of a payment negotiation between the provider and the insurance company.

Patients may continue receiving surprise out-of-network bills for services prior to today for some time, because the billing ban only applies to patient visits that take place after today, and the billing process sometimes takes weeks or months. However, consumers should no longer receive these bills for any trips to the hospital or ER starting today.

“It’s critical that consumers are informed about these new protections,” said O’Brien. “It’s possible that some health care providers may continue sending these bills, either in error or, in some cases, in an attempt to take advantage of consumer confusion. Consumers need to know that they have recourse if they are improperly billed.”

If Oregon consumers receive a surprise out-of-network bill for health care services provided today or after at a facility that is in their health plan’s network, they should contact their insurance company and the Oregon Department of Consumer and Business Services to file a complaint.

“We also encourage Oregonians to contact OSPIRG directly if they experience problems with surprise out-of-network bills,” said O’Brien. “We are here to be your advocate.”