Surprise Balance Billing
States are taking the lead to address surprise balance bills – charges for unexpected, out-of-network medical care – by enacting consumer protection laws that range from strict requirements for network service disclosures to outright bans on balance billing in certain circumstances. NASHP is tracking state efforts to mitigate surprise billing and analyze the outcomes of these measures.
As COVID-19 diagnoses grow, states are making rapid-fire adjustments so consumers can access the care they need. One key strategy has been promoting health insurance enrollment to protect consumers from potentially exorbitant medical bills. Recognizing more protection is needed, state insurance regulators are also making sure consumers maintain their coverage, find appropriate care, and are […]
As unemployment rates rapidly rise and more individuals seek new health coverage options, states are preparing for an influx of new Medicaid and insurance marketplace enrollees. While the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) provides significant support for a broad array of services, its $600 a week in additional unemployment compensation could […]
During this public health emergency, new federal laws (HR 6201, HR 748) are making significant steps to eliminate consumer cost-sharing for coronavirus (COVID-19) testing, diagnosis, and prevention while states are working to increase insurance access and surprise billing protections. The recently passed Families First Coronavirus Response Act includes several provisions that expand the ability of Medicaid and the […]
Information below references federal bills developed prior to January 2019. For an updated version of this chart, click here.
Surprise balance bills occur when patients receive unanticipated charges for health care services because they were unaware that care was delivered by an out-of-network provider or facility. In some cases, surprise balance bills can amount to hundreds if not thousands of dollars in medical expenses. A growing number of states have passed or are proposing […]
Consumer out-of-pocket spending on health care costs, including “surprise” medical bills – often incurred for costly, out-of-network care — is on the rise and state lawmakers are responding with legislation to protect consumers. Surprise bills happen when consumers receive unexpected charges for medical care that they assumed would be comprehensively covered by their insurance plans. […]
As health care costs and consumer out-of-pocket expenses continue to rise, states are paying increasing attention to strategies that address consumer concerns. One issue of focus is the practice of balance or “surprise billing,” the process by which patients receive higher than expected bills from providers, often the result of receiving care out-of-network. In April […]
As the newly insured use their coverage, increased scrutiny is being drawn toward the experiences of consumers who are receiving care. One issue of growing concern is the accumulation of medical debt, even among the insured. According to a recent study from the Kaiser Family Foundation, more than a quarter of adults in the United […]