The Office of the Insurance Commissioner (OIC) announced it will be extending the dispute resolution process under the state’s Balance Billing Protection Act (BBPA) through at least June of 2025. In response to OIC’s request for information, WSHA submitted comments supporting extension of the BBPA process.
OIC’s announcement cited pending litigation and ongoing issues with the federal Independent Dispute Resolution (IDR) process under the No Surprises Act.
The state’s BBPA dispute resolution process applies to state-regulated carriers (individual and small group) as well as self-funded groups that have elected to participate in the BBPA. The BBPA uses a “commercially reasonable” payment standard and median payment amounts established through the state’s all payer claims database for its dispute resolution process. Hospitals and providers may want to consider if some disputed out of network claims, including those for ERISA self-funded groups that may have elected to participate under the BBPA can be resolved through the state’s process. More information is on the OIC Website. (Andrew Busz, andrewb@wsha.org)
