States Are Taking New Steps to Protect Consumers from Balance Billing, But Federal Action Is Necessary to Fill Gaps

This year has seen a flurry of state-level action to protect patients from surprise balance billing. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley, Kevin Lucia and Maanasa Kona take a closer look at the latest set of state bills to tackle the issue. They find that lawmakers’ approaches to solving this problem are evolving. Continue reading

Successfully Splitting the Baby: Design Considerations for Federal Balance Billing Legislation

The U.S. Congress is advancing legislation to protect patients from surprise medical bills. Yet consensus on how to resolve payment disputes between providers and health plans has been difficult to reach. In their latest post for the Health Affairs Blog, Sabrina Corlette, Jack Hoadley, and Kevin Lucia break down different policy approaches, their pros and cons, and how recent state action could suggest a path forward. Continue reading

States Leaning In: Washington Doubles Down on Efforts to Shore up Market, Protect Consumers

In the wake of federal actions to roll back the Affordable Care Act’s reforms, states have assumed an even greater role in protecting consumers and ensuring market stability. Washington State, a long-time leader in state health insurance reform, has taken up that mantle. Since our last post highlighting Washington’s policy playbook, the state has implemented several more policies to preserve their insurance market and bolster consumer protections. CHIR’s Rachel Schwab takes a look at some of the state’s new developments. Continue reading

New York’s Law to Protect People from Surprise Balance Bills is Working as Intended, but Gaps Remain

New York’s 2014 law to protect consumers from surprise out-of-network medical bills has been touted as a model for other states and even potential federal legislation. In their latest report for the Robert Wood Johnson Foundation, CHIR experts Sabrina Corlette and Olivia Hoppe share findings from a case study of how New York’s law has affected patients, providers, and insurers, 5 years post-enactment. Continue reading

New Georgetown Issue Brief: 50-state Survey of State Action to Protect Consumers from Surprise Medical Bills

Balance billing occurs when a consumer who is treated by an out-of-network provider is subsequently billed by that provider for the difference between what their health plan paid and what the provider charges. In their latest issue brief published by the Commonwealth Fund, Kevin Lucia, Jack Hoadley, and Ashley Williams analyzed laws in all fifty states and the District of Columbia to understand the current scope of state laws that protect consumers from balance billing. Continue reading