Dual Endorsement for Out-of-Network Medical Care
HB2562

• In Virginia, insurers may choose to send payment to patients for medical care rendered by non-participating physicians.  In many cases these checks are cashed and the funds are spent for purposes other than to pay for the medical service that was provided.  The fact that the funds are not used as intended often results in financial hardship for patients and serves to reduce payment remitted to providers.
  
• Dual Endorsement legislation would require the addition of the physician’s name to the check sent to a patient for out-of-network medical care.  This simple change would make the endorsement of both the patient and the physician necessary to cash the check.
  
• Dual Endorsement legislation would ensure that these funds are spent for their intended purpose.  Similar models exist within Virginia’s business community, including the mortgage industry, and work extremely well.  
   
• Dual Endorsement legislation would NOT increase patients’ balance bills from out-of-network providers and would NOT change the payment amount of the insurer’s check.  The checks would continue to be mailed to patients, as is currently the case.  Dual Endorsement would ONLY add the physician’s name to the check, requiring both the patient’s and the physician’s signatures to cash the check.   
   
• Direct payment to physicians would be preserved as an in-network advantage; out-of-network physicians would continue to incur the work and expense of billing their patients for payment. 

Key points regarding Dual Endorsement Legislation:

HELPS patients by protecting them from the unnecessary financial hardship incurred when they cash and spend insurance checks, rather than remit these funds for payment.

HELPS Virginia physicians receive payment for services rendered in good faith.

HELPS Virginia businesses by preventing the unaffordable waste of healthcare dollars.

HELPS Virginia’s courts and businesses by eliminating judgments and wage garnishments as a means to collect healthcare payments that are sent to patients and used for other purposes.

HELPS Virginia by recovering lost tax revenue, as insurance proceeds retained by patients are not reported as taxable income.  Under a Dual Endorsement model, funds will either remain in the possession of the insurer (if the check remains uncashed) or will be declared as taxable income by the provider.

NO change in payments made by insurers.  The insurance company’s payment will be no different than under the current system.
 

NO change in patients’ balance bills. 

Dual Endorsement only requires that the physician’s name be added to the insurance check, which will prevent these funds from being spent for non-medical purposes.

Keep Virginia’s healthcare dollars in the healthcare system. 

Support Dual Endorsement for out-of-network medical care.