Resolution 18-111

Submitted by: Richmond Academy of Medicine

WHEREAS,       it is becoming increasingly difficult for patients to protect themselves from surprise medical bills, and

WHEREAS,       patients are often not aware that specialists such as anesthesiologists, radiologist, ER physicians, etc. do not accept their insurance even though the hospital is in network, and

WHEREAS,       charges from out-of-network providers contribute to about a third of medical debt cases that non-elderly adults are struggling with, according to a survey conducted by the Kaiser Family Foundation and the New York Times, and

WHEREAS,       surprise coverage gaps are created by insurance carriers narrowing networks, a lack of transparency in pricing and costs, and a proliferation of high deductible plans that offer affordable premiums but often leave patients underinsured, and

WHEREAS        at the July, 2018 meeting of the Virginia Health Insurance Reform Commission, attendees were told by participating legislators to come up with a solution or the legislators would come up with their own and such solution(s) would likely not be favorable, therefore be it

RESOLVED,     that MSV supports a physician’s ability to accept assignment of benefits and to balance bill patients that have coverage through a managed care organization with whom the physician does not have a contractual relationship, and be it further

RESOLVED,     that MSV work to eliminate payment of assignment of benefit to patients in the instance of payment for physician care, and require those payments be made to physicians.

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