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Hospital Pricing Disputes and Reference-Based Pricing Health Plans
Craig Gottwals via Substack; registration may be required 
Mar. 5, 2025 "This memo examines the legal framework governing hospital pricing disputes ... where a patient has agreed to pay for medical services but was not provided with a specific price beforehand.... The primary focus here is how courts evaluate hospital charges' enforceability and whether patients or insurers may be compelled to pay the full chargemaster rate. The analysis extends to the role of Reference-Based Pricing (RBP) health plans, particularly those governed by ERISA ... This memo assesses the legal standing of such plans in disputes over hospital pricing." MORE >> |
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