Author Archive: CHIR Faculty

Coronavirus Exposes Big Gaps in the U.S. System Of Coverage: What Can States Do to Help?

The cost of medical care associated with the novel coronavirus can be a barrier for many people who should get tested, raising a public health risk. Given our patchwork quilt system of health insurance coverage and the lack of a timely and comprehensive federal response, CHIR’s Sabrina Corlette and Kevin Lucia consider actions states can take to encourage people to get the care they need.

How States Are Using Independent Dispute Resolution to Resolve Out-of-Network Payments in Surprise Billing

As Congress and a number of states craft legislation to protect consumers from surprise out-of-network billing, a critical issue is resolving how insurers will pay out-of-network providers for their services. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley and Maanasa Kona assess the experience of states that use an independent dispute resolution process to determine these payments.

Addressing Surprise Billing by Setting Payment Standards for Out-of-Network Providers

The thorniest issue in pending legislation to protect consumers from surprise medical billing is how to resolve disputes between payers and providers over appropriate payment. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR experts Maanasa Kona, Jack Hoadley, and Katie Keith examine the seven states that have adopted a payment standard for out-of-network bills.

States Take Action on Health Care Sharing Ministries, But More Could Be Done to Protect Consumers

In the last year, state regulators have stepped up their scrutiny of health care sharing ministries to warn consumers of their limits. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s JoAnn Volk and Justin Giovannelli look at recent state action to protect consumers from the risks of health care sharing ministries and map out other options for states to step up their scrutiny of these arrangements.

Update on Federal Surprise Billing Legislation: New Bills Contain Key Differences

Congressional leaders are racing to meet a self-imposed May deadline for passing legislation to protect consumers from surprise medical billing. In their latest post for the Commonwealth Fund’s To the Point blog, Jack Hoadley, Beth Fuchs, and Kevin Lucia identify key similarities and differences among competing proposals, and provide a comprehensive side-by-side guide to the key committee bills.

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.

Protecting Patients from Air Ambulance Surprise Balance Bills – Where Are We Now?

A recently released report by the Health Care Cost Institute finds that the average price of an air ambulance trip has increased significantly from 2008 to 2017, a Department of Transportation advisory commission is studying the industry’s billing practices, and legislation is pending in Congress to protect patients from surprise bills sent by air ambulance companies. CHIR’s Maanasa Kona and Sabrina Corlette provide an update on the recent activity.

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.