Surprise Medical Billing in Michigan

Surprise Medical Billing in Michigan

New legislation passed by Governor Gretchen Whitmer has made surprise medical billing in Michigan an illegal practice.

The law prohibits medical providers from sending large bills to patients receiving out of network care on an emergency basis, known as balance billing. For people receiving non-emergency care, the out-of-network provider must provide a disclosure form to the patient two weeks before the scheduled appointment explaining that their insurance may not cover the entire visit and could be responsible out of pocket.

Jeff Romback, deputy director at the Michigan Association of Health Plans says, “The biggest thing — and I think it’s the goal that both sides agreed on — is we wanted to get the patient out of the middle. If you get that surprise bill, you really don’t know who to blame or who to call, but you’re on the financial hook for it, and they could go to collections against you.”

Under the new law, medical bills that require out-of-network emergency services will be negotiated with the preferred provider and the out-of-network carrier, no longer leaving the burden on the patient. It took over a year to pass this law through the Michigan state legislator, taking significant revisions along the way.

Michigan becomes the 31st state to pass some sort of legislation regarding surprise medical billing. These unexpected expenses can be quite costly to individuals, and it makes it an even tougher pill to swallow, given the patient does not usually know about the bill until they receive it. Hopefully, the remaining 29 states who do not have such legislation can pass something akin to the Michigan law preventing their citizens from paying unexpected medical bills.

Texas is a state that does prevent surprise medical billing in emergencies and when they do not have a choice of doctor. The law applies to all state-regulated insurance plans but does not apply to people with Medicare or out of pocket plans. In summary, if you could not choose the provider for some medical emergency, Texas will prevent any surprise bills from coming your way.

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We hope this information on Surprise Medical Billing in Michigan is helpful to you.

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