Washington surprise billing law would shrink out of network charges2 min read
A bill increasing protections from surprise billing is awaiting Gov. Jay Inslee’s signature after having passed the Legislature.
Insurance Commissioner Mike Kreidler requested House Bill 1688 to help align the Balance Billing Protection Act with the federal No Surprises Act, which went into effect on Jan. 1, 2022.
Through the No Surprises Act, all consumers – including those with self-funded health plans and federal employees – would have new billing protections when getting emergency care, non-emergency care from out-of-network providers in in-network facilities and air ambulance services from out-of-network providers.
Congress has given added flexibility to states with strong billing protections, such as Washington, to align the new federal law with state protections.
Previously, if consumers had health coverage and received care from an out-of-network provider, their health network would not cover the entire out-of-network costs, which would leave many with much higher costs than if an in-network provider saw them.
This is common in emergencies, Kreidler’s office said, where consumers might not be given choices on providers and might receive care by an out-of-network provider at an in-network hospital.
Kreidler thanked several Washington state legislators for their leadership on this issue after hearing from several consumers.
“We heard so many heartbreaking stories from consumers about their battles with surprise medical bills,” he said in a statement. “I’m incredibly proud of the bipartisan law we created several years ago and that the federal government followed in our footsteps. Now, we have the best of both laws.”
Through the new rules aimed to protect consumers, excessive out-of-pocket costs are restricted, emergency services will be covered without prior authorization and regardless of whether or not a provider or facility is in-network.
If enacted, HB 1688 would also prohibit health insurers or medical providers from asking patients to waive these protections.
This article was originally posted on Washington surprise billing law would shrink out of network charges