New legislation aimed to help resolve surprise billing woes

On Special Assignment

When a freak accident left a New Mexico woman fighting for her life, the hospital dealt her a whole new round of pain; one that hundreds of New Mexicans face. But since News 13 reported the problem on Special Assignment, there have been some major changes for the better.  

“I was in a coma for two, almost two-and-a-half weeks, brain surgery, the whole works,” Samantha Hunt said during an interview with News 13 back in February. She recalled the night in 2015 that landed her in an El Paso hospital with a traumatic head injury. 

“My fear was she wasn’t gonna survive, and I believe that if she hadn’t had the surgery within the hour, she would have died,” Samantha’s dad, Terry Riordan, told KRQE News 13. 

Samantha was country dancing in Alamogordo when a flip with her dance partner went terribly wrong and she landed on her head. 

El Paso doctors saved her life, but just like so many other New Mexicans, she got hit with a massive surprise bill — $95,000.  

Even though she was insured, the El Paso Hospital billed her for being “out of network.” Had she made it to UNM Hospital that night, her insurance would’ve covered emergency care. 

“I was in tears, because I was like, ‘this can’t be right,'” Samantha told KRQE News 13. 

After threats she’d be sent to a debt collector, Samantha and her dad filed a complaint with New Mexico’s Office of Superintendent of Insurance, or OSI. 

And they weren’t alone. “Our department has not been prepared for the large number of complaints that have occurred,” said Superintendent of Insurance, John Franchini. He said a study found one in every five policy holders in the state had a surprise bill. 

It was one in two for people who made a trip to an emergency room.

He told KRQE News 13 back in February, “We know that this is a problem and we need to help fight this,” 

More than two years after her accident, Samantha’s case was finally resolved. 

But what about other victims of surprise billing? 

The OSI tells News 13 it has since added new management and the office is working more efficiently, so cases don’t fall through the cracks.

They also received public feedback on new legislation to introduce next year. If it passes, the intent it to streamline resolutions when it comes to surprise billing in emergency situations, and involve the consumer less.

It’s now been three years since the accident that almost took Samantha’s life. 

“It’s a miracle,” her dad told News 13 back in February. “I’m just thankful that she’s here, that’s all.” 

He’s now proudly answering to the title of “Grandpa,” after Samantha recently gave birth to a baby girl.  

According to the OSI, people often end up just paying the surprise bills or letting them go to collections, so there’s a big push from their office to educate consumers that people do have recourse if they receive a surprise bill

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