- Florida and California are looking to follow New York's lead in protecting patients from unexpected out-of-network medical charges, which occur when a patient is treated by an out-of-network provider at an in-network facility resulting in the process known as balance billing.
- According to a 2015 Consumers Union survey, 37% of patients who had ED visits, hospitalizations or operations over the past two years received a bill their plan did not cover as expected. Almost 1 out of 4 recipients of surprise bills received them from providers they did not expect.
- Even healthcare professionals themselves have been victims of such surprise bills, and bipartisan efforts to address the issue have caught on around the U.S., Modern Healthcare reports.
Experts suggest there is fairly universal agreement that patients should be protected from unexpected bills. But questions remain around how to resolve payment to the out-of-network providers.
The state of New York instituted a mandatory dispute resolution system last year, Healthcare Dive previously reported.
Florida passed a patient protection bill last month that awaits the governor's signature and plans to develop a voluntary resolution process. Healthcare stakeholders are said to generally support the Florida bill, except for anesthesiology and radiology groups.
California is still examining the issue and is re-trying a similar bill for the second time. “When people get these bills, it makes everyone look bad, and there's a common interest in getting this resolved," Health Access California Executive Director Anthony Wright told Modern Healthcare.