Concerns about Indiana’s surprise billing proposal


INDIANAPOLIS, Ind. – A discussion happening in the Statehouse could result in higher or lower medical bills, depending on who you ask.

It all stems from bills meant to address surprise billing.

“Surprise billing is one of the biggest issues we are facing this session because Hoosiers are all seeing extremely high health care costs,” said Indiana Sen. Jon Ford (R), one of the authors of the legislation.

Insurance companies and healthcare providers say the proposed laws could drive those costs even higher depending on final language.

“The bill as it is written is 100% leaning toward the insurance company and so it more or less allows them to set a rate for whatever I get paid for what service I’m doing,” said Dr. Christian Ross with the Indiana State Medical Association.

Some health providers want lawmakers to set up an arbitration process.

“We can go to a third party and have this discussion about what an appropriate rate would be,” said Ross.

Insurance companies argue that’s going to result in higher reimbursement costs and in turn, higher premiums for patients.

Those companies are pushing for other methods to determine pricing.

“We’ve done Medicare rates plus 200%. So, you basically double the Medicare rate and that would be the reimbursement for the doctors so there is some way to negotiate that,” said Indiana Association of Health Plans Executive Director Michael O’Brien.

Health Care Cost Institute data shows physician fees in Indiana cost employers 22.5 percent less than the national average.

The Indiana State Medical Association says without independent dispute resolution, providers will leave the state.

“We’re not going to be able to recruit emergency physicians, we are not going to be able to recruit specialists in the state so, it’s actually going to decrease the network,” said Ross.

The one thing everyone agrees on is taking the patient out of the middle.

“It’s just striking that balance,” said Sen. Ford. “And I think at the end of the day, you’ll see some sort of resolution process in the bill.”

Ford doesn’t know what that will look like but he does know it’s going to take some time to work a compromise.

“This will be something we will be working on right up to the very end,” said Ford.

This bill is expected to be heard some time next week.

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