How 4 states are handling surprise medical bills

States across the country have passed laws designed to protect patients from surprise medical bills.

These laws typically address bills that occur after patients unintentionally receive out-of-network care in emergency situations or at in-network hospitals. 

Four things to know about the laws:

1. New Mexico's surprise-billing law takes effect Jan. 1. It requires insurers to pay for nonemergency care by an out-of-network provider in certain situations, such as when medically necessary care is unavailable within the insurance company's network, according to JDSupra. The news service reported that the law, by July 1, will also require licensed healthcare facilities to post consumers' rights information.

2. Texas' new surprise-billing law, signed by Gov. Greg Abbott June 14, also takes effect Jan. 1. The law bans surprise medical bills in circumstances where patients are unable to choose the provider they see or the facility they visit, said one of the bill's authors, Sen. Kelly Hancock, R-North Richland Hills. The law covers medical emergencies and out-of-network lab and imaging work.

3. California's surprise-billing law, in effect since 2017, addresses unexpected patient bills for out-of-network, nonemergency physician services at in-network hospitals by paying out-of-network health professionals a benchmark, locally negotiated market rate.

4. Florida passed a surprise-billing law in 2016. Patients who receive out-of-network care at an in-network facility are only on the hook for the in-network fee. Public radio station WUSF reported that the rest of the charges must be worked out between physicians and insurance companies, via a dispute resolution process.

 

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