Senator Paul Wieland’s Health Insurance Protection Bill Approved by the Missouri Senate

Senator Paul Wieland’s Health Insurance Protection Bill Approved by the Missouri Senate

JEFFERSON CITY — On Monday, April 23, the Missouri Senate approved Senate Bill 982. The legislation, sponsored by Sen. Paul Wieland, R-Imperial, is one of the first bills in the nation addressing issues surrounding insurance companies denying payment for an emergency room visit. Senate Bill 982 also solves surprise insurance billing which occurs when someone goes to an in-network health care facility and is seen by an out-of-network doctor.

Recently, an insurance company has enacted policies allowing them to deny coverage for an emergency room visit based on the resulting diagnosis, rather than the symptoms that sent a person to the emergency room. Senate Bill 982 reinforces the “prudent layperson” standard which states that if a person with an average knowledge of health and medicine believes immediate medical care is required, the emergency room visit would be covered by health insurance. The bill also ensures that a licensed physician reviews each case, so a computer system cannot deny a claim based on how it was coded.

“Senate Bill 982 is about consumer protection,” stated Sen. Paul Wieland. “If a reasonable person believes they need to visit the emergency room because they are displaying potentially life-threatening symptoms, these visits should be covered. Senate Bill 982 simply protects Missourians and ensures they receive the care they need when they need it.”

Senate Bill 982 also addresses a situation referred to as surprised billing. Currently, many hospitals in the state subcontract physicians and other health care providers. Because these individuals are contracted and not employed by the facility, the doctor that sees an individual may not be in their insurance network, even though they chose to go to an in-network facility.

“Unfortunately, this is an instance that consumers, who do everything right in an emergency situation, get caught in the middle,” Senator Wieland said. “This legislation ensures the consumer is removed from the situation while giving the insurance company and the health care provider ample opportunity to negotiate a fair rate. As the bill moves to the Missouri House of Representatives, I would encourage citizens to contact their representatives and help make this legislation a priority.”

For more information on Senate Bill 982 and Sen. Wieland’s other legislation, please visit his official Missouri Senate website at www.senate.mo.gov/wieland.

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