2017-05-25 / Editorial

The wrong kind of surprise: bills

Legislative Lowdown
by Rep. Martin Grohman

Have you had a surprise medical bill? You slip and fall getting out of your car and twist your ankle badly. So you go to the emergency room, get an X-ray, and good news: it turns out the bone is not broken. You’ve got a bad sprain and just need ice and rest. It was a bad day, but it could have been worse, and fortunately, you have health insurance. The hospital is in your network, and you only had a co-pay. But wait a minute: when the bill comes, there’s a $500 charge for radiology?

What’s radiology and how did that charge get on your bill? Why, with your health insurance, do you have this bill? It’s just the kind of surprise you don’t want.

It turns out the radiologist who read your X-ray was not in your health insurance network. It wasn’t your fault, and you had no way to know that – no one even asked you.

At the same time, your hospital is doing its best with limited resources. Your care is their highest priority. There are hundreds of health insurance plans and the hospital staff may not have been provided the latest information about which radiologist, pathologist or anesthesiologist is in a particular insurance plan. It’s a complex problem, and it creates unnecessary cost and expense.

That’s why, together with Consumers for Affordable Health Care, I’m submitting legislation that won’t allow surprise medical billing. Your health insurer and your care provider will be required to communicate more frequently, update their provider directories and protect you.

Have you been affected by a surprise medical bill? I’d love to hear your story. It would help me craft the legislation. Let’s find a way to fix this problem. Email me at martin.grohman@legislature.maine.gov or call me at 283-1476.

Rep. Martin Grohman (D-Biddeford) is serving his second term in the Maine Legislature. Outside the legislature, he is chairman of the Solid Waste Commission in Biddeford, and the owner of a small company called Hellocycle which does alkaline battery recycling by mail. Grohman especially supports business growth and entrepreneurship. Sign up for updates at www.growmaine.com or facebook.com/ repgrohman.

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