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Surprise Medical Billing Guidance for Governors

States are increasingly focused on the effect surprise medical bills have on consumers. In 2018, 39 percent of patients said they had received an unexpected medical bill, according to a Kaiser Family Foundation survey.

In response, 11 states have enacted consumer-oriented laws to address surprise medical bills since 2017, including six states in 2019.

To support governors seeking new strategies to mitigate this issue, the National Governors Association (NGA) issued key considerations for state governors. The considerations are based on a roundtable discussion among state officials, national experts, health plans, providers, hospitals, consumers, and researchers from across the country.

The NGA summarized stakeholders’ discussion and reported comprehensive approaches states may consider to confront aspects of surprise medical billing, such as:

  • engaging key stakeholders;
  • establishing comprehensive consumer protections;
  • establishing limits on reimbursement for surprise medical bills; and
  • expanding application and enforcement of surprise medical billing protections.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Kelcie Jimenez is a former state policy analyst at America's Essential Hospitals.

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