Collector - July 2020 - 25

WASHINGTON

2020 LEGISLATIVE OUTLOOK

Washington state has also tackled
balance billing with its Balance Billing
Protection Act, which amended existing
state law effective Jan. 1, 2020. The
act applies only to patients enrolled in
Washington state-regulated health plans
and provides, in part, that an out-ofnetwork provider or facility may not
balance bill an enrollee for emergency
services or nonemergency health care
services provided to an enrollee at an
in-network hospital or an in-network
ambulatory surgical facility if the
services provided involve surgical or
ancillary care and are provided by an
out-of-network provider.
The law further provides that the
insurance carrier must hold an insurance
enrollee harmless from balance billing
when emergency services are provided by
an out-of-network hospital in a state that
borders Washington state. The law also
requires certain disclosures to be made
by health care providers and insurers.
While there is no private right of action for
violations, the law allows state regulators to
levy fines or apply other remedies available
under law. For more information, review
RCW Section 48.49, et seq.

States appear to remain interested in
legislating surprise billing in 2020. Maine
has already enacted 2020 L.D. 2105, which
extended the state's existing surprise billing
law to address bills for out-of-network
emergency services. Likewise, Virginia
recently enacted 2020 H.B. 1251, which
amended the state's existing surprise billing
law to include emergency services.
At the time of publication, ACA was
tracking legislation related to surprise
billing in a number of other states, including
Arizona, Connecticut, Georgia, Hawaii,
Idaho, Kansas, Kentucky, Louisiana,
Minnesota, Maryland, New Jersey,
Oklahoma, Rhode Island, South Carolina
and Vermont.
As states continue to regulate surprise
billing, and with a federal law likely on
the horizon, ACA-in conjunction with
its affiliated state units-will continue to
monitor these legislative proposals in order
to represent the interests of the accounts
receivable management industry and convey
any relevant compliance information to ACA
members.

COLLECTOR 07.20

Andrew Pavlik is ACA International's
compliance analyst.

1

While there isn't a federal
law addressing the
practice of balance billing,
there are two bills under
consideration in Congress.

2

Almost 30 states have
enacted some level of
surprise billing protection,
with other states considering
similar legislation.

3

Work with your health
care clients to ensure
they are complying with state
laws to prevent bills that may
be subject to balance billing
restrictions from being placed
in collections.
25



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