Nevada providers, insurers hopeful for consensus this year on surprise billing solution

Nevada legislation to address surprise emergency bills could be closer to fruition, The Nevada Independent reported.  

Surprise emergency bills can occur when a patient is transported to a hospital that is not in their insurance company's network. Patients may also receive a surprise bill if they visit an in-network emergency room but are treated by an out-of-network provider.

Lawmakers are expected to consider the issue in the next legislative session, and hospitals, physicians and insurers are optimistic that they can reach a consensus this year on a bill, according to the report.

"I would say that we're in a better position today than we have been in the past," Bill Welch, CEO of the Nevada Hospital Association, told the Independent. "This is the first time in the 20 years that I've been doing this that I've seen the focused effort during the interim to try to bring a resolution."

Multiple resolutions have been proposed. Lawmakers will reportedly consider a bill that calls for payers and payees, such as hospitals and physicians, to agree on a "reasonable" rate for out-of-network services provided or else use arbitration, as well as a proposed constitutional amendment that would limit hospital charges to 150 percent of federal Medicare rates for emergency out-of-network care.

Additionally, a working group that includes various payers, hospitals and physicians has developed a bill draft request. The request includes points the group came to a consensus on — for example, that patients in emergency situations will only have to pay the amount their health plan would normally require them to pay for in-network treatment — but it does not include an agreed upon-reimbursement formula for emergency care, Nevada Democrat Assemblyman Mike Sprinkle told the Independent.

"In the end, we got a lot accomplished, but we still ultimately didn’t have one consensus piece of legislation," he said. "As soon as this bill comes out, as soon as we see the language, I'll reconstitute the working group, and we'll continue to work through the remaining issues."

Access the Independent's full report here.


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