The Biden administration appeased healthcare providers in finalizing a rule to limit costly 'surprise billing' for patients by allowing additional negotiation factors, such as a provider's experience or training, to be considered in out-of-network billing disputes.
The Biden administration appeased healthcare providers in finalizing a rule to limit costly"surprise billing" for patients by allowing additional negotiation factors, such as a provider's experience or training, to be considered in out-of-network billing disputes.
In-network providers are doctors, hospitals, and other healthcare providers that accept a person's health insurance plan, while out-of-network providers do not. Frederick Isasi, the executive director of Families USA, a nonprofit consumer health advocacy organization, said the latest regulations would"ensure fair payment to providers while discouraging abuse of the reimbursement negotiations process."
The first iteration of the rules from the departments of health and human services, labor, and treasury last October stipulated that the health plan's median in-network rates in that geographic region should be considered the correct amount for out-of-network billing.
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