Will 2018 Be the Year States Shore Up Balance Billing Legislation?

Continuing the trend of steadily increasing attention to the issue of balance billing, 2018 has wasted no time kicking off activity to move the needle in the direction of more comprehensive state legislation. Balance billing is the process by which patients receive higher-than-expected bills from healthcare providers, often due to having unknowingly received out-of-network care. Physicians' lobbies, state-level insurance departments, and state politicians have begun what is sure to be a year full of activity. 

Physicians weigh in

Recently, Physicians for Fair Coverage (PFC), a coalition of physician working on policy issues including balance billing, has weighed in on the balance billing issue by advocating that consumers be kept out of the issue between insurers and physicians. PFC recommends an appropriate and fair standard for out-of-network services using a reimbursement schedule connected to an independently recognized and verified charge-based database. To benchmark physician fees, PFC recommends FAIR Health, which it says maintains the largest collection of private insurance claims in the United States.

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