HealthLeaders Media October 14, 2021
What’s not clear is whether the new law will have the unintended consequences of shifting costs and leading to higher insurance premiums.
KEY TAKEAWAYS
– The new rule specifies that the arbitrator generally should pick the amount closest to the median in-network rate negotiated by insurers for that type of care.
– Other factors, such as the experience of the provider, the type of hospital or the complexity of the treatment, can be considered in some circumstances, but not given equal weight.
– By contrast, some state laws taking aim at surprise bills allow arbitrators to consider higher rates, such as billed charges set by providers, rather than negotiated rates, which potentially drive up spending.
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