New rules for how insurers and doctors fight over bills

Relating to mediation and arbitration between health benefit plan issuers or administrators and out-of-network health care providers.

Introduced· 2025-02-26

Who's it for

Who's it for: Healthcare providers

What it means for you

5/10Mixed

Mixed: some good, some bad ·

Right removed

Plain‑English summary, cross‑checked against the official bill text.

This bill forces health insurance companies and out-of-network doctors to play fair when arguing over who pays a medical bill.

Our take

What we think, in plain words.

When you get a surprise medical bill, your insurance and the doctor usually have to work it out with a referee, called a mediator. This bill makes sure the insurance company sends someone who actually has the power to pay the bill. If either side acts in bad faith, the referee can force them to use a private judge instead of going to a regular court. It mostly affects big companies fighting each other, not you directly.

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The facts

What the bill actually says, no spin.

Insurance companies must send a representative who has the power to agree to a payment.
Insurers must give the referee their direct contact information right away so the process can start.
If the referee thinks the insurer or doctor is acting in bad faith, they can force them to use a private judge.
If forced to use a private judge, neither side is allowed to file a normal lawsuit in civil court.
The insurance company and the doctor must split the cost of the private judge evenly.