(i) For any facility or provider that is owned and operated independently from all other businesses and that has more than fifty employees, upon confirming that a patient’s health plan is subject to the Balance Billing Protection Act: (b) Health care facilities and providers must: The specific communication requirements for hospitals under WAC 284-43B-050 are: Additionally, we know some hospitals are providing signage in their facilities, addition to the requirements below. In particular, the hospital is required to provide patients with the Standard Consumer Notice of Surprise Billing Rights when radiology services are scheduled or provided to a patient that is covered under the BBPA, which includes patients under fully insured plans and enrollees of self-funded groups that have opted into the BBPA. We want to take this opportunity to remind hospital staff of the specific responsibilities of hospitals to communicate with patients that are covered under the state’s Balance Billing Protection Act. This is particularly important if one of the two affected radiology groups provides services at your facilities. WSHA has significant concerns regarding the impact on network adequacy and access and will be contacting the Office of the Insurance Commissioner.

This situation will be a significant test of the state’s Balance Billing Protection Act.

Combined, these two groups provide radiology and radiology interpretation services for more than a third of the state’s hospitals in the state, including many small rural hospitals. WSHA was recently notified by member hospitals that United Health Group terminated its participating agreements with two major radiology groups, Radia Imaging and Inland Imaging.

Radia radiology