All posts by pdacnm

Have you experienced “Surprise Medical Billing”? Your stories are needed!

Rep. Nathan Small has introduced SB 207, the Surprise Billing Protection Act to protect consumers from this unfair billing practice. If you have a story to tell please send it to PAIGE.DUHAMEL@state.nm.us in the Office of the Superintendent of Insurance who is in support of this bill.

Surprise medical billing occurs when an insured person is treated by an out-of-network provider that the patient had no role in choosing.  This occurs most frequently in medical emergencies or major surgery situations when an insured person is treated 1) at an in-network facility for a medical or behavioral  emergency and services are provided by ancillary out-of-network providers (surgeon, radiologist, anesthesiologist, pathologist) or 2) patient receives in-patient surgery by an out-of-network provider (physician or ancillary providers) without consent of insured person and is hospitalized  or 3) with elective inpatient admissions at in-network facilities.

These surprise bills can be quite large. Patients may receive bills from multiple providers. One study showed that ambulance rides were billed out-of-network roughly half of the time.

The goals of the bill are to:

1)    Limit the amount billed for out-of- network emergency room care to what the patient would owe an in-network provider,

2)    Limit the amount billed for major surgery costs provided by out-of-network providers to what the patient would owe an in-network provider,

3)    Advise emergency patients that they could run up excess charges if they are in an out-of- network hospital; obtain statement signed by patient that they have been told and understand

4)    Eliminate “Balance Billing” or the ability of a provider to bill a covered person for the difference between the provider’s billed charges and the amount allowed by the insurance plan.  Payment disputes would be resolved by physicians and insurance and not involve consumers.

* The New Mexican Patient Protection Act allows insurers to bill only what a patient would owe an in-network provider for out-of-network emergency care.

There have been other efforts to regulate health care plans to mitigate surprise billing, including a bill introduced in Congress in 2017 by now Governor Michelle Lujan Grisham, “The Fair Billing Act of 2017.” Without federal legislation, states are stepping forward to regulate plans themselves.  Other considerations are to establish legislative guidelines for out-of-network providers to seek more payment from insurance carriers based on a formula set up by either state rules or through a federal formula.

PDACNM Newsletter, January 15, 2019

Read the Latest Newsletter Here!

2019 NM LEGISLATIVE SESSION BEGINS TODAY JANUARY 15!

After 8 years of incompetent and corrupt state government, New Mexicans can finally have hope that actual governing is going to take place and the news coming from the Roundhouse seems to affirm that hope. One of the largest concerns of New Mexicans is the depth of crime and poverty plaguing the state and it appears that our legislators (on both sides of the aisle) are recognizing the problems and addressing the crisis with bold and just legislation that will go a long way in turning our state around.  Please read the following article from the NM Political Report.

New direction, and infusion of money, seen for criminal justice system By Jeff Proctor, New Mexico In Depth

“There’s talk of a massive “omnibus” bill that would feature changes to New Mexico’s probation and parole systems, reparations for crime victims, the way law enforcement uses eyewitness testimony to seek convictions and several other laws.
Then there are the reforms that, in years past, have found support from both political parties but ultimately met the veto pen of Gov. Susana Martinez, a former prosecutor who for eight years stuck to her belief that New Mexico needed tougher penalties for lawbreakers, but largely stiff-armed proposals to address systemic injustices”

Read article here

Congratulations to Antoinette Sedillo-Lopez who has just been appointed to Senator McCorley’s senate seat.

PDACNM Monthly Meeting


PDACNM MEETING – February 13, 2019
FIRST UNITARIAN CHURCH
3701 Carlisle Blvd. NE
Albuquerque, NM 87110

5:30 – Food and Conversation
Meeting starts at 6 PM
 

Panel discussion of HB57 sponsored by Gail Chasey, a bill to restore voting rights to those still serving time in prison. Maine and Vermont are the only other states giving prisoners the right to vote. More information in future newsletters.

 

PDACNM Newsletter December 31, 2018 – Change, Progress and Challenge in 2019

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THE ARTS
President Obama’s Favorite Books, Movies and Music 2018

As 2018 draws to a close, I’m continuing a favorite tradition of mine and sharing my year-end lists. It gives me a moment to pause and reflect on the year through the books, movies, and music that I found most thought-provoking, inspiring, or just plain loved. It also gives me a chance to highlight talented authors, artists, and storytellers – some who are household names and others who you may not have heard of before. Here’s my best of 2018 list – I hope you enjoy reading, watching, and listening.

Here’s a reminder of the books that I read this year that appeared on earlier lists:
Becoming by Michelle Obama (obviously my favorite!)
An American Marriage by Tayari Jones
Americanah by Chimamanda Ngozi Adichie
The Broken Ladder: How Inequality Affects the Way We Think, Live, and Die by Keith Payne
Educated by Tara Westover
Factfulness by Hans Rosling
Futureface: A Family Mystery, an Epic Quest, and the Secret to Belonging by Alex Wagner
A Grain of Wheat by Ngugi wa Thiong’o
A House for Mr Biswas by V.S. Naipaul
How Democracies Die by Steven Levitsky and Daniel Ziblatt
In the Shadow of Statues: A White Southerner Confronts History by Mitch Landrieu
Long Walk to Freedom by Nelson Mandela
The New Geography of Jobs by Enrico Moretti
The Return by Hisham Matar
Things Fall Apart by Chinua Achebe
Warlight by Michael Ondaatje
Why Liberalism Failed by Patrick Deneen
The World As It Is by Ben Rhodes

Continue reading PDACNM Newsletter December 31, 2018 – Change, Progress and Challenge in 2019

PDACNM Newsletter December 24, 2018 – PDACNM Change of Time, Venue and Date for January

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PDA LETTER DROPS

Each month PDA members from different chapters around the country pay visits to their Senators and Representatives with letters asking them to support specific progressive legislation.  We invite you to join us.  The visits are pleasurable and productive for us and for the office staffs.  Several PDACNM folks paid a visit to Rep. Luján’s office this month to encourage him to support the Green New Deal and to thank him for co-sponsoring the resolution to stop military aid to the Saudi War on Yemen. We visited Senator Udall’s office to thank him for supporting efforts to stop US military assistance in Yemen.

If you would like to join us on these visits, please contact Laura at stokescorrales@comcast.net.