New Rules on Balance Billing

On May 21, 2019, Gov. Inslee signed the Balance Billing Prevention Act, which takes effect on January 1, 2020, that prohibits out-of-network providers from submitting surprise medical bills to insured patients for providing emergency services in an in-network facility. The Act also includes arbitration for disputes between insurers and providers regarding the price for those services; a notice requirement describing a patient’s rights and letting them know when they can and cannot be balance billed; a requirement that the amount an insurer pays an out-of-network provider must be “commercially reasonable” as determined by payments made for the same or similar service in a similar geographic area.

Balance Billing Prevention Act »