Insurers And Providers Brace For Tricky Fallout From Surprise Billing Law

Insurers And Providers Brace For Tricky Fallout From Surprise Billing Law


As the Biden administration begins to implement new protections for consumers, the health industry prepares for the changes that will have a big impact on bills for services like childbirth care and ambulance rides.

Surprise Billing Law May Create New Tension Between Providers And Patients 

At least one major source of tension remains unresolved regarding the new law banning surprise medical bills: what it looks like for patients to willingly waive their protections — or refuse to waive them. Why it matters: This could yet again pit providers’ rights against their patients’. Driving the news: The Biden administration last week released the first rule implementing the surprise billing law passed late last year, which will take effect in January. (Owens, 7/6)

Childbirth Highly Susceptible To Surprise Medical Bills 

Nearly one in five newborn hospitalizations or childbirth deliveries have at least one surprise medical bill, especially if cesarean delivery or neonatal intensive care services are provided, according to JAMA brief out Friday. Why it matters: Childbirth hospitalizations — which often out-of-network — are the most frequent sources of surprise bills in the U.S. and new federal protections addressing this issue could benefit many families, the analysis said. (Fernandez, 7/6)

The Washington Examiner:
Unexpected $36K Air Ambulance Bills Expected To Be History Under New ‘Surprise Billing’ Rule

The Biden administration began implementing a ban on surprise billing practices on Thursday, a step toward putting an end to unexpected charges to patients for costly healthcare services such as air ambulance rides. “This latest guidance reinforces the law’s important protections for patients facing medical emergencies, including situations where notice and consent procedures would not apply so that patients don’t become victims of a surprise bill at their most vulnerable moments,” said the lobbying group Coalition Against Surprise Medical Billing, which represents major healthcare trade groups, such as America’s Health Insurance Plans and the Blue Cross Blue Shield Association. (Morrison, 7/4)

Why An Ambulance Ride Could Cost You Thousands In Surprise Medical Bills 

There are few situations where you’re more vulnerable than when you’re being transported to an emergency room in an ambulance. The choice of having a sudden collapse or unexpected accident isn’t a choice at all; it’s a quirk of circumstance that requires immediate attention, and ambulatory services have an obligation to get a patient to a medical facility as fast as possible. (Mukherjee, 7/5)

‘An Arm And A Leg’: Tips For Fighting Medical Bills From ProPublica’s Marshall Allen

Veteran health journalist Marshall Allen has been exposing health care grifters for years. Now, he’s written a book about how to fight them. Host Dan Weissmann spoke with Allen about some of the best tips from “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.” Allen used the skills he learned while doing health care deep dives for ProPublica to write the book, which he describes as a field guide to navigating the health system. (Weissmann, 7/6)

In other news about the Biden administration —

Skeptics Question If Biden’s New Science Agency Is A Breakthrough Or More Bureaucracy 

If President Joe Biden’s last big science project was a moonshot, his new one has goals that are light years further. The proposed Advanced Research Projects Agency would deliver breakthrough treatments for cancer, Alzheimer’s, diabetes and other diseases and reshape the government’s medical research efforts, by adding a nimble new agency modeled on the Pentagon’s Defense Advanced Research Projects Agency, or DARPA, which laid the groundwork for the internet. (Owermohle, 7/5)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.


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