Health Affairs Blog reviews issue of surprise medical bills

Surprise medical bills occur when patients cannot avoid being treated by providers outside their health plan’s contracted network. | File photo

The Health Affairs Blog, a vehicle for commentary on health policy and issues affecting the health care industry, recently released an article on surprise medical bills.

“Surprise medical bills occur when patients cannot avoid being treated by providers outside their health plan’s contracted network — either because the provider is not chosen by the patient, for example the emergency department physician or the anesthesiologist assisting a surgery, or because patients are not even aware that the provider is involved in their care, such as a pathologist examining a biopsy,” the post’s authors write.

In the piece, the authors argue that a federal solution is needed. States play a role in regulating insurance markets, but the problem differs widely in various states. Additionally, states cannot protect more than half of commercially insured consumers because the Employee Retirement Income Security Act of 194 exempts close to 100 million people from regulation by states because their plans are self-funded by their employers.

The article was written by Loren Adler, associate director of the Center for Health Policy at the Brookings Institution; Mark Hall, a nonresident senior fellow in the Economic Studies program at Brookings; Caitlin Brandt, senior research analyst in the Center for Health Policy; Paul Ginsburg, director of the Schaeffer Initiative for Innovation in Health Policy; and Steven Lieberman, a non-resident fellow — economic studies at the Center for Health Policy, Brookings Institution.

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