New state law protects patients, families from medical bills

New state law protects patients, families from medical bills
The new law sets up a good faith arbitration process for resolving billing disputes between insurers and health care providers if they are unable to agree on a commercially reasonable payment amount. (Source: Pixabay)

RICHMOND, Va. (WWBT) - Virginia lawmakers passed a new law that protects patients and their families from receiving unexpected medical bills after they have already paid their fair share of health insurance costs.

The new law sets up a good faith arbitration process for resolving billing disputes between insurers and health care providers if they are unable to agree on a commercially reasonable payment amount.

Patients are completely removed from that process and any additional financial obligation related to it.

Bipartisan legislation, which was carried out by Senator Barbara Favola of Arlington County and House of Delegates’ Appropriations Committee Chairman Luke Torian of Prince William County, prohibits balance billing for out-of-network emergency services and certain non-emergency services at in-network facilities which includes:

  • Anesthesiology
  • Radiology
  • Surgery
  • Pathology
  • Hospitalist
  • Laboratory care

Balance billing, or surprise medical bills, typically occur in situations when an insured patient receives care from a health care provider who is not in-network with their insurance company.

When this happens, insurers often refuse to pay providers for health care services rendered, leaving patients facing an unexpected, and sometimes costly, bill.

According to JAMA Internal Medicine, more than one-third of inpatient admissions and emergency department visits from 2010-2016 resulted in surprise billing situations.

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