Surprise medical bill legislation could hurt EMS providers

Harrisburg

HARRISBURG, Pa. (WHTM) — If you’ve ever used an ambulance or entered an emergency room, you were likely hit with a surprise medical bill.

State lawmakers are looking to end that, but EMS providers say it would hurt them.

No one expects to need emergency care, yet one in three Pennsylvanians have received a surprise medical bill. It’s an issue of a medical provider being in-network versus out of network.

“Forty-four percent of Americans don’t have $400 set aside for any time of emergency situation,” said Antoinette Kraus, executive director of the Pennsylvania Health Access Network.

That’s why a bipartisan group of state lawmakers is trying to stop the practice of surprise medical bills with House Bill 1862.

“The real worry for EMS is that it puts the insurance companies in charge of how much they actually want to pay us,” said Nathan Harig, assistant chief of Cumberland Goodwill EMS. “It uses this language that the government would be setting the rate through what’s the median in-network rate.”

Harig says the bill as currently written would hurt an already struggling industry. He says the bill would set how much they can charge for their service, which he believes would be too low.

“On average, we’ve seen anywhere from 35 percent is the amount they want to pay us versus that full 100% sum that we get from being an out-of-network provider,” Harig said.

Kraus points to success in other states. “California for example, they actually saw an increase in providers being in-network, so it actually helped make sure consumers weren’t going out of network,” she said.

She did acknowledge the struggle of emergency medical service providers.

“We do need to address that issue, but the solution to addressing that issue shouldn’t be allowed to put individuals and families in a situation where they get an unexpected bill.”

The sponsor of the bill, Rep. Tina Pickett, says she is working with other lawmakers and emergency service providers on amendments before it goes to the House floor for a vote.

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