American Society of Plastic Surgeons
For Consumers

Fair Balance Billing Reimbursement

About the Issue

ASPS is committed to solving the nation's problem of unanticipated medical bills and wants to ensure patients are held harmless from billing disputes. We believe that any legislative solution should include an accessible independent dispute resolution (IDR) system and payment criteria that do not tie physician reimbursement to the median in-network rate. This is a complex issue that has the potential to limit patient access to specialty care and increase higher healthcare costs in the long run if it is rushed through Congress. That's why we support the careful and equitable deliberation of this issue through the traditional legislative process.

ASPS's balance billing principles include:

  • Removing patients from billing disputes;
  • Ensuring patient choice for nonurgent out-of-network care with informed consent;
  • Facilitation of a fair contract environment;
  • Fair and timely physician payment;
  • Adequate insurance networks;
  • And coverage of ERISA plans.

Questions to Ask the Candidates

  • Do you oppose tying physician reimbursement to the median in-network insurer rate?
  • How will you strengthen network adequacy requirements to increase patient access to in-network specialty care?