North Carolina Senate passes trio of healthcare consumer protection bills

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The North Carolina Senate nearly unanimously approved three health care consumer protection bills Wednesday.

Senate Bill 505 would require health care facilities to notify patients of any health care providers at the facility who may not be in the patients' insurance network.

Sponsors of SB 505 said the measure would reduce surprise bills, which often result from emergency room or urgent care visits at facilities that are covered by patients' insurance plans but are treated by a physician or medical professional who is not within the insurer's network.

The insurance company could opt out of paying for the services, and patients could end up being billed by the provider, oftentimes weeks later.

“Even a sophisticated consumer would assume that an in-network hospital means the services provided within that hospital are also in network,” said Sen. Joyce Krawiec, R-Forsyth, one of the bill's sponsors. “It really is outrageous. This bill will help patients make more informed decisions about their care and who is providing it.”

Sen. Julie Mayfield, D-Buncombe, said the bill does not go far enough to protect North Carolinians from out-of-network costs, especially in emergencies. She filed two amendments Wednesday to block patients from paying for out-of-network services at in-network hospitals. Both amendments were tabled.

The Senate unanimously approved SB 505, 49-0.

Senate Bill 462 would increase the dollar amount that diagnostic center equipment, major medical equipment and capital expenses for health facilities must exceed before they are required to obtain a Certificate of Need (CON) review.

Critics of CON laws believe they reduce access to health care and result in price inflation.

According to the National Conference of State Legislatures, price inflation can occur when a hospital cannot fill its beds and fixed costs must be met through higher charges for the beds that are used.

The bill also sets a deadline for construction for CON holders.

“This bill fixes the CON hoarding problem by requiring construction of a facility to begin within two or four years of CON issuance, depending on the size of the project,” said Sen. Jim Burgin, R-Harnett, one of the bill's sponsors. “This will bring an end to CON hoarding, which will increase health care supply and lower costs.”

The Senate approved SB 462, 48-1.

Senate Bill 228 would allow small business owners to offer employees the same health plans as large employers. The bill authorizes them to provide Exclusive Provider Organization (EPO) plans where out-of-network services would not be covered. Small employers currently can offer only Preferred Provider Organization (PPO) plans in the state.

“The trade-off for not offering consumers out-of-network providers is that EPO plans cost 15–20% less than PPO health insurance plans,” said Sen. Chuck Edwards, R-Henderson, said.

The Senate unanimously approved SB 228, 49-0.

The bills now advance to the House for consideration.





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