ACEP Approves Fair Payment - Balance Billing Policies

ACEP News 
July 2009

The ACEP Board of Directors recently approved a new policy statement on fair payment and revised the College's policy statement on balance billing.

Earlier this year, the California Supreme Court prohibited balance billing by out-of-network emergency care providers in the state. In addition, there have been a number of state legislative efforts to enact a ban on balance billing in several states.

As a response to these developments, ACEP President Nick Jouriles, M.D., appointed a subcommittee of members of the Reimbursement, State Legislative/Regulatory, Coding and Nomenclature, and Federal Government Affairs Committees to review ACEP's existing policy on balance billing and consider new strategies to help chapters effectively address the issue in their states.

The subcommittee presented its recommendations to the ACEP Board of Directors at its April meeting, and the new policy positions were approved.

In addition to recommending revision of the balance billing policy and adoption of a new policy on fair payment, the subcommittee also created other resources to assist chapters in dealing with this issue. These include a document outlining the principles of fair payment and model fair payment legislation. This model legislation would permit the elimination of balance billing, but only if key provisions are in place that ensure that out-of-network emergency care providers are paid fairly.

The new policy statements, the principles document, and the model legislation are available in the State Advocacy section of the ACEP Web site, along with previously developed talking points and resources to help chapters combat efforts to ban balance billing.

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