Recent Work
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Breaking Down The Bipartisan Senate Group’s New Proposal To Address Surprise Billing
Like other recent federal bills (and state laws), the bipartisan Senate legislation protects patients from surprise out-of-network bills through a “billing regulation” approach.
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Analyzing the House E&C Committee’s Bipartisan Surprise Out-Of-Network Billing Proposal
The Energy and Commerce draft would eliminate surprise out-of-network billing for both emergency and non-emergency services (with the notable exception of ambulance services) and across different sites of care (e.g., hospitals, ambulatory surgery centers (ASCs), freestanding emergency departments).
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The Relationship Between Network Adequacy and Surprise Billing
As policymakers look to address surprise out-of-network billing, network adequacy regulation is raised as a potential solution. Researchers from the USC-Brookings Schaeffer Initiative argue the network adequacy framework is poorly suited to solving this problem.
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State Approaches to Mitigating Surprise Out-of-Network Billing
Schaeffer Initiative researchers explore why surprise out-of-network billing occurs and how federal and state governments can respond to eliminate these surprise bills and reduce inflated health care costs.
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Reducing Unfair Out-of-Network Billing — Integrated Approaches to Protecting Patients
It may be possible to balance the competing goals of consumer protection and market innovation in state and federal oversight of health plan networks, according to a new opinion piece in The New England Journal of Medicine.