N.J. Lawmakers Seek To Crack Down On Surprise Out-Of-Network Medical Bills

FRANKLIN LAKES, N.J. (CBSNewYork) -- Has it happened to you?

You go to a hospital for a procedure for a doctor who you believe is in your medical plan – only to find out the other staff are not. And the next thing you know, a hefty out-of-network bill not covered by your health insurance arrives.

As CBS2's Christine Sloan reported, lawmakers want to stop such things from happening in New Jersey, and some residents have taken a stand.

"This time I had had it – I actually crossed it out and said, 'I do not agree,'" said Tony Cristiano of Franklin Lakes, New Jersey.

Cristiano is taking a stand after his wife went into labor at Valley Hospital in Ridgewood, New Jersey. He refused to sign admissions papers that he said ambiguously warned of being billed for out-of-network costs.

Cristiano said he chose the hospital specifically because it was in his health insurance plan.

"How many people have actually gone for a medical procedure and then got these bills, and had their credit rating damaged or couldn't pay?" he said.

The hospital charged him more than $1,800 for an anesthesiologist who was not in his network.

"What normally seems to be the case at Valley Hospital is they have one group of anesthesiologists," Cristiano said. "It's kind of like a monopoly."

Valley Hospital has not returned CBS2's call, but Assemblyman Gary Schaer (D-Passaic) said most patients are not warned of out-of-network charges.

Schaer and other lawmakers have created a bill to force medical providers to explain charges clearly, and to work with patients to resolve billing issues.

"I am going to take them on, and I told; I warned them. I said, 'I will take this -- I will take it all the way,'" Cristiano said.

Andrew Groh said he got slapped with a $1,500 out-of-network bill for his son's sprain. He said they went to Hackensack University Medical Center in Westwood, assuming that it was affiliated with the main hospital in Hackensack.

"She said, 'Well, we're not affiliated with that hospital,'" Groh said. "And I was in disbelief, because their name and their logo is on the outside of the building."

The Westwood hospital did not return a call from CBS2. Groh said he has no intentions of paying the bill.

Lawmakers said they will first hold a summit with doctors and hospitals, and then introduce the bill sometime in June.