Virginia on the Right Track to Curb Surprise Medical Billing

Washington, DC – The ERISA Industry Committee (ERIC) supports Virginia regulators’ efforts to advance rules implementing the state’s recent legislation to curb surprise medical billing because the rules deter surprise billing in ways that do not increase health care costs for patients.

“During a time when many Virginians face economic hardship, it is vital for states to pursue efforts to curb the predatory practice of surprise medical billing,” said James Gelfand, Senior Vice President of Health Policy, ERIC. “The proposed Virginia regulations are a model of how state lawmakers can protect their residents while working with employers to keep health care affordable.”

In comments submitted to the Virginia State Corporation Commission, ERIC applauds the state for its work to curb surprise medical billing in the state, while not imposing additional mandates on self-funded group health plans. ERIC appreciates that the proposed rules allow large multi-state employers – whose benefits programs are governed exclusively by the federal Employee Retirement Security Act (ERISA) – to voluntarily opt-in to the patient protections.

Additionally, ERIC’s comments supported the State’s proposal to rely on the median, in-network reimbursement rates, rather than the inflationary, non-market rates providers have demanded. Still, ERIC recommends that the rates should be carrier-specific, as the state’s All-Payer Claims Database will include the median in-network rates for all carriers through all paid claims, but those rates may not be applicable across carriers. By rejecting inflated out-of-network bills in the calculation, the proposed rule in Virginia encourages less gaming of the system, less surprise billing, and ultimately lower costs for patients.

“Employers want employees and their families to have access to high-quality providers, and believe those providers should be compensated fairly. What they do not want is for a medical emergency to put their employees in a financial crisis because of outrageous health care costs.”

Click here to read ERIC’s comments.

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All media inquiries to The ERISA Industry Committee should be directed to:

Kelly Broadway, 202.627.1918, kbroadway@eric.org

About the ERISA Industry Committee
ERIC is a national advocacy organization that exclusively represents large employers that provide health, retirement, paid leave, and other benefits to their nationwide workforces. With member companies that are leaders in every sector of the economy, ERIC advocates on the federal, state, and local levels for policies that promote flexibility and uniformity in the administration of their employee benefit plans.