The No Surprises Act says patients can't get hit with pricey, unexpected medical bills. Some experts say the regulation could also slow the growth of health insurance premiums.
that provisions in the No Surprises Act could reduce premium growth by 0.5% to 1% in most years, but also noted an estimate from the Centers for Medicare & Medicaid Services that premiums could slightly increase. Neither study isolated the effect of the arbitration guidelines from the rest of the statute.
Adler noted that relying heavily on the median in-network price likely means lower payments compared with other measures but, still,"by definition a median is what half of what doctors get paid, so this could, in theory, raise that for the other half."What's likely, health policy experts said, is that the new law will prompt more providers to join insurer networks.
Some physicians — most often, emergency room doctors, anesthesiologists and radiologists — have avoided signing contracts with insurers. Instead, they typically have set charges above the level of insurers' reimbursement and have sent surprise bills to patients for the difference.
Adler said that argument doesn't fly when looking across the experience of states with similar laws. "Every single surprise billing debate has done the opposite and pushed more people into the network," he said.Once the law takes effect,"it's completely irrelevant whether an emergency room doctor is in network or not," he said."For all intents and purposes, that doctor is in network. The patient will pay the in-network cost sharing and there is a price the provider has to accept, and the insurer has to pay.
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