Jim Rosica
Ending “balance billing,” overhauling the state’s insurance laws, and preserving a practice called “prior authorization” are among the goals of the Florida Association of Health Plans for this legislative session.
The organization, which represents every health insurer in the state other than Florida Blue, released its priority list on Monday.
“FAHP consistently supports legislative proposals that promote access to comprehensive, affordable, quality health care, and this session is no different, as we will be actively advocating in favor of policies that build upon that principle,” said FAHP President & CEO Audrey Brown in a statement.
Putting a stop to balance billing is high on the list, she said. Her group also has the support of Chief Financial Officer Jeff Atwater and his Insurance Consumer Advocate, Sha’ron James.
Balance billing happens when an out-of-network provider directly bills insured patients to cover costs their insurance company didn’t pay. The practice can result in surprise bills into the thousands of dollars that most people can’t afford to pay.
A bill (HB 221) by state Rep. Carlos Trujillo, a Miami Republican, “will hold the consumer harmless in emergency situations, paying no more than what you would pay if the provider had been in your insurance network,” Atwater said last week.
State Sen. Rene Garcia, a Hialeah Republican, is backing the Senate companion.
Brown’s organization also supports legislation (SB 1170/HB 951) “that would modernize Florida’s Insurance Code by repealing burdensome measures that are unnecessary and ultimately do nothing but increase the cost of health care to Floridians,” she said.
Those measures, sponsored by state Sen. Nancy Detert of Venice and state Rep. Travis Cummings of Orange Park, both Republicans, “would repeal existing Florida requirements in three areas that are no longer relevant: certificates of creditable coverage, outline of coverage, and conversion and continuation of coverage.”
And Brown said she’ll be “on the lookout” for any legislation “that seeks to change the current, effective method of utilizing prior authorization.”
According to HealthCare.gov, it means a “decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary … Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost.”
” … We look forward to working with legislative leaders over the course of 2016 Legislative Session toward our collective goal of providing Floridians with access to affordable, quality health care,” Brown said.
