The Massachusetts Society of Pathologists, with CAP support, joined the Massachusetts Medical Society and other specialty societies in urging the Massachusetts Division of Insurance to pause efforts to establish a default payment rate for out-of-network (OON) health care services.
What they’re saying: From an October 8 letter:
“Since the passage and implementation of the federal No Surprises Act (NSA), the Medical Society has consistently recommended that Massachusetts allow the NSA framework to govern in lieu of adopting a separate state-level process. The NSA comprehensively regulates all fully- and self-funded plans and reflects a carefully negotiated, bipartisan compromise informed by individual states’ experiencing and addressing surprise billing. Most importantly, it provides comprehensive patient protections against surprise medical bills while establishing a process for resolving payment disputes between health plans and providers.”
The groups urged Massachusetts to pause development of a default OON payment rate while the state gathers and evaluates updated data on OON billing, patient protections, network participation, and use of the federal dispute resolution process.