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Analysis

Washington State Emergency Order Bans Surprise Lab Billing for COVID-19

By Alexandra Wilson Pecci  
   June 04, 2020

The order aims to prevent surprise bills for lab fees related to medically necessary diagnostic testing for COVID-19 and is effective through July 31.

An emergency order from Washington State insurance commissioner Mike Kreidler has banned surprise billing related to COVID-19 lab testing.

The order aims to prevent surprise bills for lab fees related to medically necessary diagnostic testing for COVID-19. It applies to both in-state and out-of-state labs.

It's effective through July 31.

The emergency order also encourages health insurers to the Washington insurance commissioner's office if out-of-network laboratories are not publishing cash prices or if they don’t accept the published cash price as final payment for COVID-19 diagnostic testing.  

Washington State also recently implemented the Balance Billing Protection Act, effective January 1, 2020.

The new measure prevents consumers from getting a surprise or balance bill if they receive emergency services and are treated by an out-of-network provider. It also prevents a surprise or balance bill if a patient is treated at an in-network hospital or surgical facility and are treated by an out-of-network provider. 

In related news, Kreidler's office also extended another emergency order requiring Washington State health insurers to waive copays and deductibles for any consumer requiring testing for COVID-19.

The order is extended an additional 30 days, applying to all state-regulated health insurance plans and short-term limited duration medical plans until July 3. 

Insurers also must continue to suspend prior authorization requirements for COVID-19 treatment or testing and allow enrollees to be treated by another provider within a reasonable distance at no additional cost if it does not have enough medical providers in its network to provide testing or treatment for COVID-19.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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