Questions Remain Over Effectiveness Of Legislation To End Surprise Medical Billing

By Consumers For Quality Care, on August 4, 2021

According to Healthline, despite stronger rules and oversight to protect consumers from surprise billing set to take effect next year, patients should remain vigilant against “holes” in the law that could still lead to bills they were not prepared to pay.

A recent study from the Kaiser Family Foundation estimated that one in five emergency claims and one in six in-network hospitalizations included at least one out-of-network bill. While the law clearly states that providers must notify patients about out-of-network charges, experts question how it will affect overall prices within the larger health care system.

“It’s possible that it could lead to lower in-network prices and lower premiums. Or it could lead to higher in-network prices and higher premiums,” Dr. Christopher Garmon, assistant professor of health administration at the University of Missouri – Kansas City said. “The jury is still out on that, and that’s where a lot of the research will be conducted in the future to try to determine what effect this will have on healthcare costs throughout the healthcare system.”

The legislation is not without gaps – for example, it currently does not protect patients from surprise ground ambulance bills.

While many health care experts are cautiously optimistic about this legislation, lawmakers must remain proactive to put an end to toxic hospital debt collections practices and protect consumers from all forms of surprise billing.