Public hearing on balance billing scheduled in Pennsylvania

Pennsylvania Insurance Commissioner Teresa Miller announced last week that her department will hold a public hearing about balance billing on Oct. 1.

The hearing comes after “dozens” of complaints about have piled up from customers who thought their procedure was in-network and covered, only to receive bills at a later date due to out-of-network care.

"It is critical that we address this issue in order to protect consumers from getting an unexpected bill from a provider," Miller said in a statement. "When someone faces a health issue such as surgery, treatment in an emergency room, or even a routine procedure, they should be free from worrying about facing financial hardship once they return home."

The most common balance billing-related problem has been from out-of-network providers assisting with additional care—specialties such as radiology, for example—after the patient was believed all care would be covered by their insurance.

"These patients made an assumption that many would—if the hospital is in-network, then the doctors and other healthcare professionals working there are in-network, too," Miller said in the same statement. "This is not always the case, and while consumers do bear responsibility to check who is in-network, to expect a patient or their family to research every possible health care provider they may see while in a hospital is asking too much of people whose main concerns are the health issues they face."

The hearing begins at 10 a.m. at the State Museum in Harrisburg, Penn., and goes until 1 p.m. It will be streamed live online.