Tag: balance billing

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

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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.

March Research Round Up: What We’re Reading

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Spring has arrived, and the research is blooming! This March, CHIR’s Olivia Hoppe was buzzing around studies on direct enrollment, balance billing from air ambulance rides, affordability for middle-income consumers, and the roles of assisters and support tools.

State Efforts to Protect Consumers from Balance Billing

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While the U.S. Congress is considering multiple proposals to combat the problem of unexpected balance billing for health care services, several states have moved ahead. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley, Kevin Lucia, and Maanasa Kona share findings from a 50-state review of balance billing protections.

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

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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.

Georgetown Experts Help States Weigh Solutions to Protect Consumers from Unexpected Medical Bills

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As reports of patient encounters with unexpected provider bills continue to make headlines, state and federal policymakers are working to find solutions to the problem of surprise out-of-network billing. A recent Georgetown report on the issue caught the eye of two states – Pennsylvania and Florida – that are attempting to set new standards to protect consumers from balance bills. CHIR’s Ashley Williams shares a summary of what these states heard from our report’s lead authors.

The Next Big Thing in Network Adequacy: The NAIC Model Act

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In November, the National Association of Insurance Commissioners (NAIC) will finalize the Network Adequacy Model Act – a draft bill designed to be used by states to enact provider access standards for private health insurance plans. Consumer representative Claire McAndrew explores what the act includes as well as areas for improvement.

New Georgetown Report: Assessing Consumers’ Experience with ACA Coverage through the Eyes of State Consumer Assistance Programs

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While the ACA has successfully resulted in 16.4 million newly insured people, we don’t yet know a lot about how that new coverage is working for them. However, state consumer assistance programs (CAPs) have the eyes and ears on the ground to help identify problems or gaps in private insurance coverage. Georgetown researchers surveyed 10 state CAPs and found many common issues for consumers’ coverage experiences, pre- and post-ACA.

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.