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4 New Surprise Medical Billing Laws to Know

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January 10, 2020

In four states, new laws targeting balance billing took effect Jan. 1.

Here’s a quick summary of what each law entails:

Colorado: HB19-1174 limits what out-of-network physicians can charge at in-network hospitals. It also creates an arbitration process to settle billing disputes, according to Colorado Public Radio.

Nevada: AB469 blocks hospitals and physicians from balance billing most patients for emergency treatment administered by out-of-network providers. Providers and insurers will be required to resolve the bill on their own or use an arbitrator, according to The Nevada Independent.

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Texas: SB1264 requires insurers and healthcare providers to refrain from balance billing and settle out-of-network billing disputes through an arbitration process. It bans emergency balance billing in most cases. The bill only pertains to Texans with state-regulated health plans, or about a third of those with private health insurance, according to The Texas Tribune.

Washington state: R2019-04 leaves patients only responsible for paying in-network prices at hospitals that are a part of their insurer’s provider network. All other negotiations will remain between the hospital, physician and insurer. Self-funded employer plans can opt in or out of the bill, according to KOMO News.

Source: Becker’s Hospital Review

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