New Hampshire considers safeguards against balance billing

January 20, 2018 GMT

CONCORD, N.H. (AP) — New Hampshire patients would be better protected against surprise medical bills under legislation being considered by House lawmakers.

The House Commerce and Consumer Affairs Committee held public hearings on two bills this week aimed at addressing what’s known as “balance billing” — when patients who are treated at hospitals in their insurance networks get billed by individual providers such as anesthesiologists who are out-of-network.


Nearly half the states already offer at least some consumer protection measures, but New Hampshire rejected a 2016 bill that would have required in-network facilities such as hospitals to hold consumers harmless when an out-of-network provider rendered services at the facility. After studying the issue this fall, a legislative committee drafted a new bill that narrows the scope for anesthesiology, radiology, emergency medicine and pathology.

The committee’s recommendations were based on an assumption that the providers in question are out of network due to disagreements with insurers about payment levels, and they attempt to address providers’ concerns about network adequacy requirements. The changes might make the bill more palatable to lawmakers, said Rep. John Hunt, a Republican from Rindge and chairman of the commerce committee. But some of providers affected by the proposal oppose it, he said, and its fate is uncertain.

Jennifer Patterson, health policy legal counsel for the state insurance department, said she is fairly confident the bill will advance given the committee’s thorough examination of the issue. While there are no hard numbers on how often patients experience balance billing, it’s clear that “consumers are caught in the middle,” she said.

According to a June report by the Commonwealth Fund, 21 states protect consumers from balance billing for care delivered in emergency departments or in-network hospitals, but only six cover both settings. Researchers found that 14 percent of emergency visits were likely to produce a surprise bill as were 9 percent of hospital stays.