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New Illinois Law Prevents Some Providers From 'Balance Billing' Patients for Care at In-Network Surgery Centers

A new Illinois law blocks providers of radiology, anesthesiology, pathology, neonatology or emergency room services from "balance billing" patients who have received care from an in-network ambulatory surgery center, according to a Life and Health Insurance report.

The new law took effect June 1. "Balance billing" occurs when a healthcare provider receives a payment from a patient's insurer, then bills the patient directly for the difference between the amount charged and the amount paid by the insurer. Insurers typically use provider contracts that prohibit in-network providers from "balance billing" plan members, but patients who seek out-of-network care typically have no guard against balance billing.

Lawyers at McDonald Hopkins LLC in Chicago have argued in a suit filed recently at the U.S. District Court for the Northern District of Illinois that the balance billing law is unconstitutional. They allege that the idea of applying balance billing restrictions to only a few types of physicians is arbitrary and unfair.

Read the Life and Health Insurance report on the new Illinois law.

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