Patients commonly face unexpected bills when they end up receiving care from out-of-network providers and are held responsible for the difference between the provider’s charge and what their insurer will pay.
This “surprise medical billing” can happen in emergency care situations, or even when patients have chosen in-network providers or facilities, but out-of-network providers are brought in to participate in their care.
A team led by Karan Chhabra, M.D., analyzed various pieces of surprise-billing legislation proposed in the last session of Congress, and presents their findings in a new article on the Health Affairs Blog.
The team concludes that elements of these previous efforts, as well as state-level policies already in place, can offer a strong foundation for current legislative approaches to curb surprise-billing practices.
The team conducted their analysis as part of an IHPI Policy Sprint that is looking at the extent to which different types of providers contribute to out-of-network billing in surgical care, with the aim to inform the national conversation around policies to reduce surprise billing.