According to the ruling, even the minimum standards of payment are “not necessary” in states that have banned balance billing. Balance billing occurs when health plans pay unreasonably low reimbursements, and physicians are forced to bill patients for the unpaid “balances” (similar to how a dentist bills). Health insurance companies have taken gross advantage of patients and emergency medical providers since the ACA, arbitrarily slashing payments to physicians by as much as 70 percent. Obviously, this is a concern in the ED when we are required to treat every patient regardless of their ability to pay or if their insurance company will cover the cost of their care. This type of legislation may particularly impact smaller, independent groups that have no choice but to use balance billing when insurance companies refuse to properly reimburse them.
More information about this from ACEP can be found here.
INSURANCE INDUSTRY DRIVES PATIENTS TO SACRIFICE NECESSARY MEDICAL CARE. This news release from October 2015 discusses how underpayment by insurance companies impacts our patient’s access to care and our ability to treat them in the ED.