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'Oh, Cluck': New Ad Campaign Spotlights Costly Abuse of Surprise Billing Law

"As abuse and misuse of the No Surprises Act continues from some private equity-backed and out-of-network providers, a new ad campaign highlights how misaligned incentives create a ‘fox guarding the hen house’ dynamic, allowing bad actors to flood the law’s independent dispute resolution (IDR) process with outrageous, often ineligible claims.... Without meaningful guardrails, oversight, or accountability, the IDR process has so far added more than $5 billion in excessive costs that employers and consumers ultimately have to pay."  MORE >>

State Legislator Aims to Tweak Georgia Surprise Billing Law for Self-Funded Health Care Plans

"House Bill 234 aims to amend Title 33 under Georgia Code by providing an option for self-funded health care plans exempt from state regulations under federal law to opt-in to Georgia's Surprise Billing Consumer Protection Act.... [Rep. Lee Hawkins] said that the bill that would allow such health care plans to voluntarily agree to comply with the Surprise Billing Consumer Protection Act's provisions isn't in conflict with ERISA."

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In California, a 'Surprise Billing' Law Is Protecting Patients and Angering Doctors

"Three years ago, California passed one of the strongest laws in the country to outlaw surprise medical billing. That legislation made sure that when patients went to a hospital covered by their insurance, doctors couldn’t later ambush them with unexpected bills. Now lawmakers who want to ban surprise bills nationally are gravitating toward a California-style approach, making the California experience a key exhibit in the debate."  MORE >>

Arkansas Bill Makes Second Attempt at Any-Willing-Provider Law

Excerpt: A bill filed with the Arkansas Legislature on Tuesday would prohibit managed care networks from practices that 'discriminate' against doctors and hospitals, a move the bill's sponsor says will put an 'any willing provider' law into effect. Senate Bill 43 is intended to open closed insurance networks such as those of Arkansas Blue Cross and Blue Shield, allowing health-care providers who are willing to meet an insurer's terms to see patients at in-network rates, said ...

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Pennsylvania's Governor Rendell Signs Common Law Marriage Bill (PDF)

2 pages. Excerpt: On November 23, 2004, Governor Rendell signed into law HB 2719, abolishing common law marriage. The new law states that '[n]o common law marriage, contracted after January 1, 2005, shall be valid.' The law further provides that it does not invalidate an otherwise lawful common law marriage contracted on or before that date. As a result, most, but not all of the issues presented by a series of court decisions relating to common law marriage have been resolved.

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New Colorado Surprise Medical Billing Law Arbitration Provisions, Explained

"Colorado joined the handful of other states that have begun to put in place consumer protections addressing surprise bills when its new out-of-network [OON] law ... took effect on Jan. 1, 2020.... The OON Law will not apply to ... self-funded plans ... Additionally, the protections in the OON Law do not apply to a patient who voluntarily chooses to use an out-of-network provider or facility instead of an in-network provider or facility."  MORE >>

Loopholes Limit New California Law to Guard Against Lofty Air Ambulance Bills

"[T]he new air ambulance law is like laws in California and other states that protect consumers from surprise medical bills: They don't apply to residents in federally regulated [self-funded] health plans. Those plans cover about two-thirds of people who get insurance through their jobs nationwide.... [W]hen other states have tried to prohibit air ambulance balance billing, the companies have often successfully challenged those laws on the grounds that the federal Airline Deregulation Act of 1978 prohibits state rate setting[.]"  MORE >>

One Not-So-Big Summary of the Compensation and Benefits Law Changes in the One Big Beautiful Bill Act

"After having been left out of the initial House bill, the Act includes the long-awaited telehealth extension.... Although employees may want to take advantage of the increase in the DCAP contribution limit, employers should continue to run and monitor DCAP nondiscrimination testing ... Employers that want to offer [Trump Account] contributions to their employees will need a formal plan document and will need to comply with certain nondiscrimination testing rules."  MORE >>

No Surprises: Congress Enacts Surprise Bill Law and Adds Mandatory Billing Transparency

"To date, approximately 22 states have enacted protections against surprise billing.... [S]tates cannot regulate ERISA health plans and thus cannot fully protect all consumers. The No Surprises Act will therefore extend surprise billing protections to ERISA plan beneficiaries, as well individuals in states without protections.... [S]tates are explicitly empowered to enforce the No Surprises Act and if they do so, they will be the primary mechanism of enforcement."  MORE >>

New York City's Expanded Safe and Sick Leave Bill Becomes Law

"To be ready to comply with the new Law by February 22, 2026, New York City employers should: [1] Review and update their leave policies to reflect the new requirements, particularly the separate bank of unpaid sick and safe time. [2] Remove any policies related to the TSCA. [3] Train managers on the new law so that they may be able to handle requests by employees for leave."  MORE >>