Alcohol exclusion laws lead to balance billing disputes in 24 states

Some health plans in 24 states have exclusions that enable insurers to deny members medical coverage for injuries that occur while intoxicated.

Alcohol exclusion laws permit insurance companies to deny payment for medical services related to alcohol or drug use. Legislators passed nonpayment laws starting in the 1940s as a way to deter drinking and driving, according to NPR. However, the laws have led to heated balance billing disputes between payers, hospitals and patients to assign financial responsibility.

Alcohol exclusion laws can also affect how hospital personnel administer medical care in emergency departments. Faced with the prospect of not receiving payment for services, some ED personnel may sidestep the problem by simply not testing patients' blood or urine for alcohol.

However, critics argue alcohol and drug screening is an important step that can aid in prosecution of offenders and medical interventions, according to NPR.

Since 2001, 15 states have enacted laws that prohibit insurers from implementing alcohol exclusion policies.

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