The Wolf administration is floating a proposal that would end medical balance billing in situations in which out-of-network providers are involved in the delivery of care patients receive from providers they believe to be in their health insurer’s provider network.
Such situations typically arise when patients receive inpatient care at hospitals they know to be within their insurer’s provider network but some of the professionals involved in providing that care are not part of that network.
insurance deptThe results can be large bills for services their insurers do not cover.
The Pennsylvania Insurance Department has published draft legislation to address such balance billing and is seeking public comment on the proposal. See that draft legislation here.