HOUSE CONCURRENT RESOLUTION 108

(By Delegates Ellington, Summers, Fleischauer and Campbell)

[Originating in the Committee on Health and Human Resources; Reported on March 8, 2016]

Requesting the Joint Committee on Government and Finance to study and review surprise medical bills and the impact it has on the populous of West Virginia.

WHEREAS, The term “surprise medical bill” is commonly used to describe charges arising when an insured individual inadvertently receives care from out-of-network providers; and

WHEREAS, A surprise medical bill occurs during two different occasions. Firstly, the situation arises when the patient has no ability to select the emergency room, treating physician, or ambulance providers and ends up with an out of network provider; and

WHEREAS, Situations may also arise when a patient receives planned care from an in-network provider, often, a hospital or ambulatory care facility, but the other treating provider brought in to participate in the patient’s care is not in the same network. These providers can include anesthesiologists, radiologists, pathologists, surgical assistants, and others; and

WHEREAS, The out of network provider will then bill the patient for charges that have been incurred by the patient, resulting in more expenses and stresses for the patient to deal with; and

WHEREAS, A national survey found that 8% of privately insured individuals used out-of-network care in 2011; 40% of those claims involved surprise involuntary out-of-network claims; and

WHEREAS, A study conducted by the New York Department of Financial Services that involved more than 2,000 complaints involving surprise medical bills found that the average out-of-network emergency bill was $7,006. With the insurer paying $3,228, leaving the consumer to pay $3,778 for an emergency in which they had no choice; and

WHEREAS,  In 2015 The State of New York has implemented the nation’s first comprehensive approach to preventing surprise medical bills from out-of-network providers in emergency situations and non-emergency situations; and

WHEREAS, Sound solutions to the problem of surprise medical bills should be addressed in order to reduce the burden on the residents of West Virginia; therefore be it

Resolved by the Legislature of West Virginia:

That the Joint Committee on Government and Finance is hereby requested to study and review the practice of surprise medical billing; and, be it

Further Resolved,  That the Joint Committee on Government and Finance report to the regular session of the Legislature, 2017, on its findings, conclusions, and recommendations, together with drafts of any legislation necessary to effectuate its recommendations; and, be it

Further Resolved, That expenses necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.