The state enacted the so-called 80th percentile rule to address “surprise” billing for out-of-network providers nearly 20 years ago.A major insurance provider wants it gone.The Alaska State Medical Association says it should stay.
State officials want to repeal a policy established nearly 20 years ago to protect Alaska ns from surprise medical bills that’s now beingSome, like the Alaska State Medical Association and numerous physicians, say repealing the rule would remove an important consumer protection and could lead to higher health care costs for patients and fewer specialists, particularly in rural Alaska .
Under Alaska’s 80th percentile rule, if an insurance company receives 10 bills for similar medical services in a particular region, the seven lowest cost bills are paid in full by the insurance company, and the other three are paid at the rate of the third-highest of those bills. one of the state’s largest insurance companies. “Because the message to providers is, others got paid more than you. So the next time you file a claim or a bill for that service, you’re going to increase it.”Experts disagree on what will happen if the regulation is repealed: doctors say Alaskans’ medical costs could go up, insurance companies say removing the rule could lead to a reduction in health care costs over time.
He thinks the 80th percentile rule has helped Alaskans avoid unusually high medical bills for out-of-network care, and sees removing it as a risk.
State Care Insurance Study Provider Rule Network Regulation Health Providers Compton Premera Bills Costs Bill Cost Scenario Service Rate Alaska Time Insurance Company Patients Patient
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