Today, ERIC provided comments to the Virginia State Corporation Commission’s Bureau of Insurance, in response to their notice “Ex Parte: In the matter of Adopting New Rules Governing Balance Billing for Out-of-Network Health Care Services” (CASE NO. INS-2020-00136) on surprise medical billing regulations in the state.
ERIC was originally opposed to Virginia’s surprise medical billing legislation (SB 172), which passed on March 5. However, the proposed regulation now includes:
- Clarification between fully-insured health plans, which are regulated on the state level, and those that are self-insured and thus governed exclusively by the federal ERISA law
- Self-insured plans may voluntarily “opt-in” to the regime that will protect their employees from surprise medical billing
- Provider payments will be based on the median, negotiated in-network price, in a given geography, for a given procedure.
The proposed effective date for the regulations is January 1, 2021.
To read ERIC’s comments, click HERE.
Article by James Gelfand, Senior Vice President of Health Policy