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Gottlieb
Solutions

Your Success Is Our Success

Gottlieb
Solutions

Your Success Is Our Success

Gottlieb Regulatory Update

One April 2nd, 2019, United States House of Representatives, Subcommittee on Health, Employment, Labor, and Pensions held a meeting “Examining Surprise Billing: Protecting Patients from Financial Pain”.  In an effort to provide you with a quick review, our Regulatory Department has provided some takeaways for you:

 

Takeaways Notes

  • The witnesses testifying from Brookings Institution, American Benefits Council, Family’s USA, and Georgetown University Health and Policy Institute favored insurers over providers.
  • Studies from the Brookings Institution, Kaiser Family Foundation, and individual state studies were mentioned.
  • The 80th percentile of UCR was mentioned once while the conversation of reimbursing providers 125% of Medicare was mentioned well over 50 times.

Analysis

  • States that currently have balance billing legislation may consider reforming current laws based on the impacts of the federal legislative route. Meaning, States may take a “watch and see” approach with the success or failure of the federal legislation before they decide to reform or tackle the issue.
  • Federal legislation may mirror current balance billing legislation in California, New York, and Connecticut.

Our team will continue to monitor legislative and regulatory changes to keep you informed.

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