Defining financial responsibility for uncollected co-pays, co-insurance and deductibles
If enacted, SB 758 would significantly impact state laws pertaining to healthcare billing practices and insurance reimbursements. By establishing a clear obligation for carriers to reimburse providers for uncollected amounts, the bill aims to alleviate financial burdens on healthcare providers and promote equitable funding for healthcare services. Furthermore, it introduces stricter conditions under which healthcare providers must demonstrate collection efforts, thereby potentially reducing the volume of claims perceived as bad debt.
Senate Bill 758, introduced by Senator Barry R. Finegold, seeks to define and enforce financial responsibility regarding uncollected co-pays, co-insurance, and deductibles in the Commonwealth of Massachusetts. The bill amends Chapter 176O of the General Laws, mandating that healthcare carriers must reimburse providers for a minimum of 65% of unpaid patient obligations after reasonable collection efforts have been made by the providers. This addresses the persistent issue of healthcare providers bearing the brunt of financial losses from uncollectible patient payments, allowing them to maintain financial stability while serving patients.
The bill also raises concerns about how the reimbursement process will be administered and the definition of 'reasonable collection efforts' expected from providers. Critics might argue that the requirements could impose additional operational complexities and administrative burdens on smaller healthcare practices. The potential for disputes over what constitutes reasonable efforts and the adequacy of documentation could lead to bureaucratic delays, which may ultimately hinder patient access to necessary care if providers are less willing to treat uninsured or underinsured patients.