Houston – The American Hospital Association (AHA) and the American Medical Association (AMA) filed a lawsuit Friday over a new law that’s meant to prevent you from getting stuck with surprise medical bills.
Let’s say you went to the emergency room, and one of your doctors was out of your insurance network. You could end up with a very high bill from that doctor.
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Congress passed the No Surprises Act, which takes effect January first, to require insurance companies to cover you for that doctor’s care. However, a battle is brewing over how that price will be determined.
“I was in a dispute and I just kept fighting it and fighting it, and then they sent me to the collectors,” said Suzie Headrich.
Headrich says she knows what it’s like to have medical debt.
“You worry about that stuff,” she said. “You go to bed worrying about it, thinking about it, and it’s just not fun.”
A Healthcare.com survey found more than one in three U.S. adults have outstanding medical bills. Sometimes, it’s thousands of dollars of debt from what’s called surprise or balance billing.
“When they unknowingly receive care from a doctor or another healthcare provider who is outside their insurance company’s network. Sometimes these bills happen in emergency situations,” explained Nancy Brown with the American Heart Association.
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“That is not the time to try to understand how you’re going to pay for this,” said Allison Sesso with RIP Medical Debt.
Additionally, the No Surprises Act requires insurers to cover the out-of-network costs through negotiation, and if that fails, through arbitration at close to the median rate for in-network services.
The American Hospital Association and the American Medical Association are suing, saying that pricing methodology favors insurance companies. The American Heart Association is speaking out for patients.
“We believe the No Surprises Act must be strongly enforced to ensure patients are protected,” said Brown.
Medical debt is such a growing problem, a non-profit called RIP Medical Debt uses donations to surprise patients by paying off their bills.
“We’ve gotten rid of over $5 billion of debt for over 3 million families,” said Sesso.
Headrich received a surprise letter from RIP, saying her debt had been paid.
“They were just explaining how they do this for people, and I just think it’s amazing. And I was just one of the lucky ones,” said Headrich.
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Consumers cannot apply for RIP’s help. The group says it pays rolls of debt at a time based on need.
But credit counseling agency Money Management International offers several tips for dealing with medical debt:
- You can dispute errors on bills, or have a patient advocate, find and dispute them for you. You can find one through the Patient Advocate Foundation.
- You can apply for financial aid from the hospital or medical provider. It can not only cut your bill, but it can also buy you more time to pay the bill. A non-profit called Dollar For can help you apply.
- Medical debt cannot appear on your credit report for 180 days. You can use that time to save up money and offer to settle the debt for less with the provider or debt collector before it appears on your credit.