WSHA Comments on Draft Out-of-Network Billing Legislation

WSHA recently provided comments to the State Office of the Insurance Commissioner (OIC) on its new draft legislation on billing and payment for out-of-network services.  The legislation specifically targets emergency services, professional surgical and ancillary services provided at facilities that are in-network with the patient’s insurance carrier.  The draft legislation would prohibit balance billing of the patient in for the services mentioned above, and would subject carriers, facilities and providers to certain payment and dispute solution requirements.   In our comments, WSHA indicated the need for carriers and self-funded payers to identify services that are subject to the provisions of the draft legislation. Additionally, we urged the OIC to ensure carriers maintain adequate networks for services provided at contracted hospitals.  OIC will consider changes based on stakeholder input and expects a bill to be introduced in the upcoming 2019 legislative session. (Andrew Busz, andrewb@wsha.org)