Tag: surprise billing

January Research Roundup: What We’re Reading

Welcome to another year of health policy research. In the first month of 2023, CHIR reviewed studies on how policies expanding health coverage would impact household spending, surprise medical bills generated by ground ambulance rides, and health care costs associated with substance use disorders.

As Ground Ambulance Committee Begins Its Work, New Report on Balance Billing by Ground Ambulance Providers Highlights a Gap in the No Surprises Act

On December 9, the Centers for Medicare and Medicaid Services announced the membership of the Advisory Committee on Ground Ambulance and Patient Billing, as required by the No Surprises Act (NSA). As the committee prepares to begin its work, there is new evidence out of Texas that the NSA’s exclusion of ground ambulance bills puts consumers at a significant financial risk when they need emergency medical transport.

September Research Roundup: What We’re Reading

It’s officially fall, and along with the new season came an autumnal bounty of new health policy research. This month, we reviewed studies on the connection between medical debt and social determinants of health, private equity acquisition of physician practices, and controlling health care costs through state surprise billing laws.

Navigator Guide FAQs of the Week: Answers to Post-Enrollment Questions

As of January 15th, the open enrollment period has ended in most states. A record number of consumers signed up for 2022 marketplace coverage. So what comes next for marketplace enrollees? First, give yourself a pat on the back for enrolling in health coverage! Second, consult CHIR’s Navigator Resource Guide for expert answers to FAQs about post-enrollment issues you may face, like unexpected coverage denials and balance bills.

Are Surprise Billing Payments Likely to Lead to Inflation in Health Spending?

Under the No Surprises Act, enacted in December of 2020, federal regulators face a balancing act as they develop a mechanism for determining payments to out-of-network providers for covered services. The law also provides for deference to state mechanisms, where they exist. In their latest post for the Commonwealth Fund, CHIR’s Jack Hoadley and Kevin Lucia assess the implications for provider payment as well as long term impacts on health care spending.

Hybrid Approach to Resolving Payment Disputes Breaks Legislative Stalemates Over Balance Billing, How Will the No Surprises Act Affect These New State Laws?

Seven states in 2020 were able to break a longstanding stalemate and enact protections against surprise out-of-network billing. CHIR’s Jack Hoadley and Kevin Lucia delve into the factors that got these states across the finish line and how the federal No Surprises Act will impact these states’ new laws.

March Research Roundup: What We’re Reading

The CHIR team is excited to transition into spring, as with the warmer weather has come some great new health policy research! This month, Nia Gooding reviewed studies on best practices for implementing the No Surprises Act, the American Rescue Plan Act’s effect on insurance premiums, demographic variations in the U.S. uninsured population, and models for implementing a public option.

The No Surprises Act and Preemption of State Balance Billing Protections

The No Surprises Act of 2020 sets up a new national framework to protect patients from surprise out-of-network medical billing. There have been numerous questions about whether and how the new federal law will preempt existing state protections. CHIR experts have prepared a handy fact sheet to walk through the nuances.

New Georgetown CHIR Report: Taking the Disputes out of Dispute Resolution

The U.S. Congress enacted the No Surprises Act in 2020 to protect patients from surprise out-of-network medical bills. Now the federal agencies need to set up a process to resolve disputes between these providers and insurance companies. CHIR experts examine the experience in four states with similar dispute resolution programs and share lessons that can be applied at the national level.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.