WSHA, Hospitals Respond to OIC Balance Billing Law Proposal

October 19, 2016

The Office of the Insurance Commissioner (OIC) recently circulated a stakeholder draft bill related to out-of-network billing, sometimes referred to as “surprise bills.” The bill is meant to address the situation where a patient receives services at a hospital or other facility that is part of their health plan’s network, but receive care from providers who are not contracted with the plan. In these cases patients can incur greater than expected costs. The OIC and legislators have indicated there will be a bill introduced for the upcoming legislative session.

The draft bill includes a number of components found in bills passed in other states, including balance billing prohibitions, notification requirements, arbitration provisions, and a default rate for out-of-network services. WSHA and other organizations have provided initial comments, though it is unclear what will be in the actual bill that is introduced. WSHA is convening a special task force of members to discuss alternative ways to deal with the issue.  (Andrew Busz,


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