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Solon seeks rules vs surprise medical bills

THE chairman of the House committee on ways and means has filed a bill mandating rules against ‘surprise medical billing’ or patients receiving unexpected bills at inflated prices and opaqueness in the prices of medical services.

Albay Rep. Joey Sarte Salceda, panel chairman, filed House Bill (HB) 8331 or the Medical Bill Transparency Act following reports of increasing cases of inflated and non-itemized medical bills at the height of the coronavirus disease-19 (COVID-19) pandemic to highlight the urgency of enacting the proposal.

“COVID-19 has increased medical bills for other medical services, primarily because of demand and lack of personnel and rooms. But there are also obvious instances of inefficiencies. Some hospitals are charging inflated prices for PPEs even when we already gave incentives to keep their prices cheap. There are regular rooms in medium-sized hospitals costing upwards of P10,000 a day. And you don’t find out until you get sick and are given the bill,” Salceda said.

Salceda cited figures derived from the Family Income and Expenditure Survey (FIES) from 2012 to 2018, which shows that up to 200,000 families per year fall into poverty because of out-of-pocket medical expenses.

“Millions of families are just one medical bill away from poverty. It is deeply immoral that the one bill that could send your family into poverty is inflated with opaque costs,” Salceda added.

Under Salceda’s bill, the Department of Health (DoH) will be mandated to enact regulations to “to require hospitals to publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format.”

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Salceda likened the situation to restaurants displaying their menus outside so that consumers can choose among various options.

He also wanted the DoH to require “the detailed itemization of actual medical bills.”

The bill also requires transparency in health insurance benefits, particularly for preventative care, according to Salceda.

The measure provides that “Secretary of Finance, to the extent consistent with law, shall issue guidance to expand the ability of patients to select health insurance plans that cover low-cost preventive care and/or medical care that helps maintain health status for individuals with chronic conditions.”

“There is plenty of opaqueness on the coverage of insurance for pre-existing conditions. It is unimaginable for a family to invest thousands every year on health insurance only to be told during an emergency that their plan does not cover the emergency due to pre-existing conditions,” Salceda said.