Michigan House Bill HB4922

Michigan 2023-2024 Regular Session

• Introduced: 7/19/23
• Refer: 7/19/23

Caption

Health: other; surprise medical billing; modify to include certain emergency medical services operations and personnel. Amends secs. 24502, 24503, 24504, 24507, 24509, 24510, 24511 & 24513 of 1978 PA 368 (MCL 333.24502 et seq.).

Impact

If enacted, HB 4922 will significantly affect how nonparticipating emergency medical services providers are reimbursed for services rendered to patients in emergency situations. The bill stipulates conditions under which nonparticipating providers can submit claims for reimbursement, including those related to a complicating factor that indicates the service was not typical. Additionally, the legislation allows these providers to file for binding arbitration when there is a payment dispute, which can help streamline processes and enhance protections for patients facing unexpected medical expenses.

Summary

House Bill 4922 seeks to amend the Public Health Code to modify provisions relating to surprise medical billing, particularly focusing on emergency medical services operations and personnel. The bill expands the definition of 'health benefit plans' and clarifies the responsibilities of both participating and nonparticipating emergency medical services in the context of billing. By establishing parameters for nonparticipating providers, the bill aims to ensure that patients are not unexpectedly billed for services, thereby protecting them from exorbitant fees often associated with out-of-network care during emergencies.

Contention

Debate surrounding HB 4922 has revolved around concerns regarding the balance of cost-sharing between patients, emergency medical service providers, and insurance companies. Supporters argue that the bill will provide much-needed consumer protection and ensure fair reimbursement practices, especially amid growing concerns over surprise billing. Conversely, opponents raise questions about the potential financial burden on healthcare providers, which could inadvertently lead to reduced access or quality of emergency services. The legislation also touches upon broader themes of healthcare accessibility and financial regulation, which are hot-button issues within the health policy landscape.