Washington governor signs surprise-billing law

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Washington Gov. Jay Inslee signed a law May 21 to protect patients from surprise medical bills.

The new law addresses unexpectedly large bills patients receive when they receive emergency services at an out-of-network emergency room or medical treatment from an out-of-network provider at an in-network hospital or facility, according to a news release from state Insurance Commissioner Mike Kreidler, who requested the legislation.

"For more than a decade, we've heard from people hit with a balance or surprise bill," said Mr. Kreidler. "They've shared their stories of receiving a bill on top of what they expected to pay, despite going to the hospital or facility their health plan covers. Many wanted to know how this could be legal. This year, we learned of two consumers who received surprise bills of over $100,000 and who both faced losing their homes and medical bankruptcy.

"I think the breadth of these stories — and that no one was immune — finally provided the motivation needed for the sides to come together and find a solution," he added.

The legislation prohibits balance billing when a patient receives emergency care in an out-of-network emergency room or has a nonemergency procedure at an in-network hospital or facility. It also prohibits balance billing when the patient receives emergency care at an out-of-network facility in a state that borders Washington. 

Under the legislation, a dispute between an insurer and provider or facility goes to binding arbitration if the parties do not agree on "commercially reasonable" reimbursement for out-of-network services within 30 days.  

 

More articles on healthcare finance: 

Patient consumerism will refine nonprofit hospitals over the long term, Fitch analyst says
Risked-based revenue rising among healthcare organizations, survey finds
California congresswoman to share surprise-billing story at hearing

 

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