From the ADVOCATE May 22, 2009 p. 8A

The Senate Insurance Committee Wednesday stripped most of the consumer protections from a controversial bill that would have prevented patients from paying much higher out-of-network costs for care at in-network hospitals.
Hospitals often contract with a single group of radiologists, anesthesiologists and pathologists. While the hospital may be part of a person’s health plan, the specialists may not.
Insurance Commissioner Jim Donelon said the result is that a patient can go into the hospital expecting to be responsible for a co-pay and deductible and find out later he or she owes thousands of dollars in out-of-network charges.
The proposed bill, which Donelon backed, would have made those additional costs the burden of health insurers.  Donelon said he was disappointed that hospitals, doctors and health insurers defeated the effort to close a loophole that costs policyholders millions of dollars a year. 
Gil Dupré, chief executive officer of the Louisiana Association of Health Plans, said forcing insurers to pay the bill in full would have led to much higher insurance premiums for workers and employers. The bill would also have removed the incentive for doctors to be part of a health network, Dupré said. Physicians would make more money by opting out of the network; eventually no one would be in the network, and health-care costs would increase even more.
The proposed bill needed a lot more revisions and a lot more consensus, Dupré said. The amended version does give consumers the right to request that services be provided by in-network physicians. It also requires hospitals to tell patients before they’re admitted that some doctors may not be part of the health plan.
Donelon said the bill’s author, Sen. Sharon Weston Broome, D-Baton Rouge, is investigating the possibility of adding back the consumer protection language when the bill goes before the full Senate. 
Dupré said the amended bill is only a first step, and the Legislature will address a solution at the 2010 session.

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