The ERISA Industry Committee (ERIC) expressed disappointment that instead of taking steps to lower health care costs – especially in these inflationary times – the Federal Departments watered down the surprise medical billing requirements that dictate how much an employer-sponsored self-insured health plan is required to pay when emergency services are furnished by an out-of-network provider and when an out-of-network provider furnishes services at an in-network medical facility. According to this Final Rule, self-insured employer plan sponsors will continue to pay inflated amounts to out-of-network providers that charge unreasonable fees. This will not only increase costs for the plan sponsor, but also for employees and their families covered under self-insured health plans.
“Unfortunately, the Final Rule falls short of lowering health care costs for employer plan sponsors, and ultimately patients. Instead of adhering to Congress’s original intent, the Administration back-tracked on limiting out-of-network payments to reasonable market-driven rates,” said Annette Guarisco Fildes, CEO, ERIC. “The Administration’s actions will not lower health care costs. To the contrary, plan sponsors and the employees they provide health coverage to will continue to be forced to line the pockets of medical providers that choose to remain out-of-network.”