The Texas Two-Step: Implementation of State Balance Billing Law Reveals Gaps in Consumer Protections

In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas. Continue reading

Department of Transportation Hosts the Inaugural Meeting of Committee to Advise on Air Ambulance Billing Issues

On January 15th and 16th, 2020, the U.S. Department of Transportation held the inaugural Air Ambulance and Patient Billing Advisory Committee meeting. Established by the FAA Reauthorization Act of 2018, the Committee is tasked with reviewing “options to improve the disclosure of charges and fees for air medical services, better inform consumers of insurance options for such services, and protect consumers from balance billing.” CHIR’s Maanasa Kona discusses some of the key takeaways from the meeting. Continue reading

New Resource for Consumer Advocates on Out-of-Network Payment Disputes in Balance Billing Legislation

State lawmakers across the country are are gearing up for a new legislative session. Many will be considering state-level protections for consumers to prevent surprise out-of-network medical bills. Just as with the federal legislation, however, one of the key sticking points for state policymakers will be how to approach out-of-network provider reimbursement. To aid stakeholders in these efforts, Community Catalyst teamed up with CHIR experts to create a guide for its health insurance reform toolkit: The Advocate’s Guide to Addressing Out-Of-Network Payment in Surprise Balance Billing Legislation. Continue reading

Disputes over Dispute Resolution: Analyses of New York & California-style Surprise Billing Protections Offer Divergent Pictures

The U.S. Congressional Budget Office (CBO) has a new analysis of legislation that would protect patients from surprise medical bills and help settle physician-insurer payment disputes through an arbitration process. CHIR’s Sabrina Corlette takes a look at their projections and three recent assessments of the effect of balance billing laws in New York and California Continue reading

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