Illustration: Sarah Grillo/Axios
The federal surprise billing ban prevented 2 million potential unexpected medical bills from reaching privately insured patients early this year, according to an analysis released by leading health plans Tuesday.
Why it matters: Insurers, providers and employers are waiting for the Biden administration to lay out a new arbitration process for settling payment disputes after a federal judge tossed out a proposed fix in late February.
Background: The surprise billing law bans many types of out-of-network medical bills and puts the onus on doctors and health plans to settle disputes or request arbitration while holding patients harmless.
A key factor: The arbiter was supposed to select the offer closest to the median in-network rate unless other information showed the rate wasn't appropriate.
- Hospitals and the American Medical Association successfully challenged that process, saying the median in-network rate shouldn't be the guiding factor.
What they're saying: America's Health Insurance Plans and the Blue Cross-Blue Shield Association said their analysis shows the process established a measure of predictability in health costs.
- If even a fraction were settled through dispute resolution, it would far exceed the government's estimate, the insurers said.