States across the country have passed laws designed to protect patients from surprise medical bills.
These laws typically address bills that occur after patients
unintentionally receive out-of-network care in emergency situations or
at in-network hospitals.
Four things to know about the laws:
1. New Mexico’s surprise-billing law takes effect Jan. 1. It requires
insurers to pay for nonemergency care by an out-of-network provider in
certain situations, such as when medically necessary care is unavailable
within the insurance company’s network, according to JDSupra.
The news service reported that the law, by July 1, will also require
licensed healthcare facilities to post consumers’ rights information.
2. Texas’ new surprise-billing law,
signed by Gov. Greg Abbott June 14, also takes effect Jan. 1. The
law bans surprise medical bills in circumstances where patients are
unable to choose the provider they see or the facility they visit, said
one of the bill’s authors, Sen. Kelly Hancock, R-North Richland Hills.
The law covers medical emergencies and out-of-network lab and imaging
work.
3. California’s surprise-billing law,
in effect since 2017, addresses unexpected patient bills for
out-of-network, nonemergency physician services at in-network hospitals
by paying out-of-network health professionals a benchmark, locally
negotiated market rate.
4. Florida passed a surprise-billing law in 2016. Patients who
receive out-of-network care at an in-network facility are only on the
hook for the in-network fee. Public radio station WUSF reported
that the rest of the charges must be worked out between physicians and
insurance companies, via a dispute resolution process.
https://www.beckershospitalreview.com/finance/how-4-states-are-handling-surprise-medical-bills.html
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