Consumers continue to suffer under the burden of surprise out-of-network bills
Across New Jersey, health care consumers continue to deal with the detrimental effects of out-of-network balance bills. Despite taking responsible measures to seek in-network care, they still often unknowingly and involuntarily receive care from out-of-network providers who, caring little for their financial well-being, send significant bills and take drastic steps to collect payment.
To further threaten consumers, the health care delivery landscape is changing. As New Jersey sees the formation of more narrow and tiered networks, and certain for-profit health care providers taking advantage of gaps in consumer protections, more and more consumers are at risk for finding themselves in situations that will increase their cost sharing and strain their resources.
Additionally, large gaps in current protections against balanced billing exist for members of self-funded (ERISA) plans. It is imperative to provide consumer-aimed protections against these financial hazards. It is time to provide the disclosure of facts that will allow consumers to make informed and timely decisions about their care, and provide adequate protections for all consumers, including those covered under ERISA plans. The Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act helps to bridge almost all of these gaps.
However, until New Jersey legislators pass this legislation, consumer stories of surprise out-of-network billing experiences and financial harm - such as those we have shared previously and share now - will continue to surface. We must act now to stop consumer bleeding through higher premiums and significant cost sharing, incurred routinely and most importantly through balance billing.