Surprise billing is heating up in Louisiana! The Senate Insurance Committee passed the legislation out of committee with a few amendments on Thursday, June 11. However, they did nothing to address our concerns! Instead, the changes add more arbitration guidance, while still basing payment decisions on billed charges and out-of-network (OON) rates, keeping special allowances for surprise billing in emergency situations, and lacking any meaningful transparency. ERIC submitted comments to the Senate Finance Committee on Friday, June 12 encouraging the members to amend the legislation prior to the bill’s hearing in the committee today (or to oppose it). ERIC was also able to submit a “red card” opposing the bill.
Surprisingly, U.S. Senator Dr. Bill Cassidy (R-LA) testified at the hearing. United States Senators testifying in state legislatures is pretty rare. He supports the legislation and believes Louisiana should pass the bill, and referenced many examples from New York’s surprise billing legislation (which we consider the gold standard for how NOT to do surprise billing reform). Cassidy claimed that New York’s legislation brings more providers in-network, lowering premiums by nine percent for those in the state – which we do not dispute… after all, prior to the NY bill’s passage, HMOs in the state were mandated to pay 100% of billed charges! So making insurers pay 80% of billed charges was a savings for that dumpster fire of a state market, even though imposing that same requirement elsewhere would be disastrous.
Senator Cassidy also said that not every surprise bill will go to arbitration; he said that only about 2,000 out of 75 million patients in the country are likely to initiate arbitration. He discussed how establishing a “loser pays” arbitration system for the state will then establish precedent, and enable an equal playing field. Senator Cassidy believes the legislation will lower out-of-pocket costs and allow more revenue in the state.
The Senate Finance Committee wants more data and information on how the legislation will impact the state and private industry, so they deferred the legislation until another fiscal note (study) could be completed. The new fiscal note may be completed by Wednesday, June 17. The fiscal note should dive deeper into the sixteen states that have surprise billing laws, including Texas, where the fiscal note will educate Louisiana members on its arbitration measures. Depending upon the information the Fiscal Office, as well as allies in the state, are able to provide, the legislation may have a chance of dying in the Committee. We will keep you updated on the next hearing!
If you are in the state, please consider contacting your State Senators and asking them to oppose Senate Bill 7.
To read our comments to the Senate Finance Committee, click here.
Article by James Gelfand, Senior Vice President of Health Policy