/Mississippi health care providers breaking the law with large medical bills that patients don’t have to pay, report finds

Mississippi health care providers breaking the law with large medical bills that patients don’t have to pay, report finds

2013 saw the Legislature pass a law to ban “balance billing”. This is when a provider bills patients for the difference in charges and amounts paid after benefits have been assigned. The law has few enforcement provisions. Patients must be aware of the law to challenge balance bills and receive benefits from it. It was passed under the radars of many health care providers and officials. Efforts to improve protections during the 2019 legislative session failed. Michelle Mills was awarded a balance bill for 2018 after her son suffered a sports injury. She went to River Oaks hospital in Flowood as part of her insurance network. However, she was treated by an outside-of-network doctor. According to a Yale University 2017 report, 65 percent of hospitals in the United States contract with outside agencies to provide emergency room doctors that are not included in their insurance. Capital Emergency Physicians, an independent physician staffing company, used Mills’ address to incorporate in 2013. It charged Mills $1853, with $38 that it requested she pay out-of pocket. Although it was illegal, Mills challenged the bill with her insurance company, which reversed the original assignment and paid the majority of the bill. Mills was successful in disputing charges. However, she stated that it was “infuriating” thinking about all those who don’t know how to challenge these bills and end up paying or worse, having their debt turned over to collections. Mississippi Today did not receive calls from Capital Emergency Physicians. Roy Mitchell, director, Mississippi Health Advocacy Program said that “Unfortunately, the collective trust of providers is being misused to the detriment our bank accounts.” He made this statement in a press release about the Harvard report. “It’s time for policymakers to level the playing field for Mississippi health consumers,” said Roy Mitchell, director of Mississippi Health Advocacy Program. The Center for Health Law and Policy Innovation of Harvard Law School reported that Mississippi’s antibalance billing law needs revision. This was the strongest and most prominent in the country. Michelle Mills, a Mississippian, reports that she still receives balance bills despite the state’s leadership. This is in violation of state law. According to a January 2019 poll, 4 out of 10 Mississippians had received or had a family member receive a surprise medical bill. House Insurance Chairman Rep. Gary Chism (Republican from Columbia) authored a bill that required the attorney general’s to enforce the law as well as establish binding arbitration to settle any balance billing disputes between patients and providers. The bill was not brought to a vote by his committee. He told Mississippi Today that many lawmakers, including nurses and nurse practitioners, opposed his bill. Chism stated that they wanted to be able get their money. A Mississippi Today analysis of the legislative members revealed that there are two nurses in the House: Rep. Becky Currie (R-Brookhaven) and Rep. Donnie Scoggin (R-Ellisville). Currie declined comment and Scoggins stated that he had not discussed the bill with Chism. Scoggins stated that he has not received concerns about illegal balance billing from constituents but said that if this continues, he would support strengthening the enforcement actions. This is because of the lack of understanding surrounding the law and the definitions of “balance billing”. If lawmakers make it clear and force providers to follow the law, what might be seen as a loophole could be challenged by the medical community. Georgia’s state legislature passed anti-balance billing legislation. This would require that insurers pay unexpected, out-of network bills at an amount determined from a database. It is not enough to prohibit providers from sending these bills. This law favors the insurers of Mississippi. A Harvard study also suggested that large surprise balance bills may be contributing to Mississippi’s high rate for people with past due medical loans — which is 37.4%.