New law protects Oregonians from surprise medical bills

As of Thursday, a new Oregon law protects consumers from receiving surprise out-of-network medical bills from health care providers. The new law prevents health providers, who were not chosen by the consumer, from balance billing services performed on or after March 1.

Balance billing occurs when an out-of-network health care provider you did not choose, such as an emergency room physician, anesthesiologist or radiologist, bills you for more than the allowed in-network charges for the following:

* An emergency service at any medical facility
* Part of a planned procedure at an in-network facility

The state Division of Financial Regulation is available to assist Oregonians who believe they have been improperly balance billed.

“It is almost impossible to choose every medical provider at a medical center that treats you, even more so in the case of an emergency,” said Andrew Stolfi, Oregon insurance commissioner. “If you are surprised by a bill from an out-of-network doctor or other health care provider, you should connect with our advocacy team immediately.”

Additionally, the law requires health care providers to inform consumers about the increased financial responsibility when choosing services from an out-of-network provider.

If you receive services from an out-of-network provider, you may still be responsible for co-insurance, co-payments, or deductibles. The new law does not prevent consumers from choosing an out-of-network provider, nor does it prevent out-of-network providers from balance billing consumers when consumers choose to see them.

If you have questions or concerns regarding your insurance coverage or a surprise medical bill connect with our advocates at 888-877-4894 (toll-free) or visit http://dfr.oregon.gov/gethelp/Pages/file-a-complaint.aspx.