Out-of-Network Billing


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.

PAMED is part of a coalition that centers around the four principles of consumer protection, fair payments, independent dispute resolution, and free market principles and limiting government's role to setting the rules for the market, protecting consumers, and avoiding direct or indirect government intervention on behalf of one party in a private negotiation.

Given the recent passage of the Federal legislation on this topic - the No Surprises Act - comprehensive protection to consumers was provided. At this time, we are asking the Pa. General Assembly to defer consideration of state level legislation pending the full implementation of the new Federal law. There still may be need for state level legislation in the future, but we won’t know until the Federal law is fully in place.


PAMED Position

  • Patients should have health care choices.
  • Physicians should be reimbursed fairly, regardless of network status. 

What is PAMED Doing About it?

  • Continues to participate in monthly Provider Coalition meetings
  • Supports the American Medical Association’s federal efforts

What Action Should I Take?
Urge your legislators to support legislation to address out-of-network billing issues. 

Billing News: