Surprise Balance Billing Study Raises Serious Questions
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Intro: Cooper paper sets organized EM back a pace This summer Zack Cooper et al gave a kick in the teeth to efforts by ACEP, EDPMA, and Physicians for Fair Coverage to try to reframe the message about balance billing … Continue reading

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Brookings Institute Misfires on Surprise Balance Billing
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Although the Brookings Institute did a fairly thorough review of the surprise balance billing issue, they missed a few key points: Their paper states: “Why should emergency providers avoid price hikes or agree to substantial discounts if the law requires … Continue reading

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Are Usual and Customary Charges Reasonable?
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In State legislative offices throughout the country where the issue of out-of-network physician charges, balance billing, and plan benefits are being debated, the constant refrain from health plan representatives is that usual and customary charges are an ‘unacceptable standard’ for … Continue reading

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CMA Stumbles Over Balance Billing Legislation in California
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AB 72, a bill that is currently on the verge of being approved by the California State Legislature, represents a serious strategic loss for physicians in California around the issue of out-of-network services (OON) and the practice of balance billing. … Continue reading

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BCBS GA Walks Back Forced Contracting Policy
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Back in May of 2016 I put a post up in The Fickle Finger on ‘Forced Contracting, BCBS’s Answer to Balance Billing’, citing a policy in the policy manual that Blue Cross Blue Shield of Georgia had put out some … Continue reading

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