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Out-of-Network Billing

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Protecting patients from out-of-network health care billing and ensuring physicians are fairly reimbursed must start with fixing the root cause of the problem – tiered and narrow health insurance provider networks and a lack of transparency.

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  • Opposes HB 1862 (House) - Would set a benchmark rate for out-of-network providers based on the median in-network rates for out-of-network care; supports two critical amendments  – Learn more

  • Supports HB 602 (House Insurance Committee) - Would prohibit a health insurer from excluding any provider in its geographic area who is willing to meet its conditions of participation

  • Opposes HB 130 (House Insurance Committee) – Would prohibit an out-of-network provider who renders mental health care, substance disorder treatment, or a treatment for a disability, from billing an eligible insured for any amount over the cost-sharing amounts that otherwise would have been imposed

  • Opposes SB 822 (Senate Banking & Insurance Committee) - Would allow the arbitrator to use Medicare rates when issuing a decision in the out-of-network dispute resolution process between the insurer and the physician
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PAMED Position

  • Patients should have health care choices.
  • Physicians should be reimbursed fairly, regardless of network status. 
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What is PAMED Doing About it?

  • Continues to participate in monthly Provider Coalition meetings
  • Supports the American Medical Association’s federal efforts
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What Action Should I Take?
Urge your State Representative to oppose HB 1862 and support critical amendments  

Take action
 

 

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