WASHINGTON STATE

Washington State House Democrats

HOUSE DEMOCRATS

Surprise Billing Ban Passes House

OLYMPIA — The House passed new legislation, HB 1065, to end the practice of balanced billing, also called surprise billing, by a vote of 84-13. Balanced billing refers to the practice of patients paying the difference between what a provider expects to be reimbursed from an insurer and what the insurer believes they should be paying. Often this amount is in dispute when a health care provider, such as an anesthesiologist, is out-of-network even when the hospital they are working at is in-network.

HB 1065 removes patients (consumers/enrollee) from billing disputes between health insurance providers (carriers) and hospitals/doctors (providers). An out-of-network provider or facility may not balance bill an enrollee for:

  • emergency services provided to an enrollee; or
  • nonemergency health care services provided to an enrollee at an in-network hospital or ambulatory surgical facility if the services: (1) involve surgical or ancillary services; and (2) are provided by an out-of-network provider.

“Imagine having to go to the hospital and having surgery. Everything goes well, you go home, and several months later you get a surprise bill from an anesthesiologist. You expected in-network status but one of the health care providers was out-of-network and you’re in the middle of a billing dispute. That’s wrong and I’m proud the House has once again passed legislation to end this practice,” said the bill’s prime sponsor Rep. Eileen Cody, D-West Seattle.

HB 1065 moves to the Senate for consideration.