November 30, 2018



 

In This Issue
Fast Facts
State Spotlight: CMS Releases Four Concepts for Waivers, Including Reinsurance Programs
CMS Introduces Enhanced Direct Enrollment for Federal Marketplace
IRS Extends ACA Reporting Deadline and Transitional Relief in 2020
NAHU Seeks Balance-Billing Stories to Shape Forthcoming Legislation
Healthcare Happy Hour: How States Can Take Advantage of ACA Waivers
HHS Adjusts Civil Monetary Penalties
Register Now for Next Week’s Webinar on Transitioning to a Fee-Based Business
December’s Compliance Corner Webinar Features a Deep Dive on AHPs
Scholarships Available for Capitol Conference
HUPAC Roundup
What We’re Reading
Tools
E-mail the Editor
Visit the NAHU Website
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NAHU Seeks Balance-Billing Stories to Shape Forthcoming Legislation

Under current law, out-of-network medical providers are able to bill patients for services that were not paid by the insurer, which can lead to patients incurring large unexpected medical costs. NAHU is working with a bipartisan group of legislators both in Congress and in state legislatures to introduce legislation to combat these balance-billing practices, and we are looking for real-life scenarios your clients have faced.

Federal legislation is likely to be introduced early next year and would address three scenarios of medical billing: emergency services provided by an out-of-network provider in an out-of-network facility; non-emergency services following an emergency service from an out-of-network facility; and non-emergency services performed by an out-of-network provider at an in-network facility. Additionally, several states are considering similar bills that we are actively working on with state chapters to inform lawmakers and improve the legislation.

The newly divided Congress will likely draft legislation that can attract bipartisan support for passage, and we believe such a bill could attract their interest and support to become a top priority in the new year. As a licensed insurance specialist who works with consumers on these issues on a daily basis, your stories can help shape this legislation, both at a federal and state level, demonstrating the changes that are needed and having meaningful impact for your clients. Share your story.

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