Starting in 2024, Illinois hospitals will be required to screen uninsured and underinsured patients
for public health insurance coverage and hospital financial assistance eligibility before pursuing
any collection action, according to JD Supra. The Protect Illinoisans from Unfair Medical Debt
bill is intended to protect patients against medical debt and reduce hospital debt as well. The bill
also requires that hospitals document when and why uninsured patients decline screening.

Starting in 2024, Illinois healthcare providers engaging in mergers and acquisitions are required
to report the transaction to the state, according to the National Law Review. Under Public Act
103-0526, providers must notify the state Attorney General 30 days prior to any merger,
acquisition, or contracting affiliation with certain covered entities. The statute builds on previous
legislation authorizing the Attorney General to bring action on behalf of a private party if a
transaction provides unfair advantages to a large business entity to the detriment of consumers
and now covers contracts with out of state entities generating at least $10 million or more in
revenue from Illinois residents.

Illinois has passed hospital antitrust legislation monitoring mergers and acquisitions, according
to Becker's ASC Review. Health care providers will now be required to notify the state attorney
general of proposed mergers acquisitions or contracting affiliations. Notification of such
transactions is one tool states can use to monitor and highlight mergers and acquisitions that
may result in increased prices for patients. Failing to provide proper notice will result in a penalty
of up to $500 per day.

Illinois will offer a discount program that will allow diabetics to buy insulin for $35 per month at a
post-rebate price, according to WAND. House Bills 2189 is intended to build on previous
legislation that capped insulin prices for only about 15 percent of the population through
insurance for state employees. Starting in 2025, program participants will be able to get official
cards from the state with information about how to request reimbursement from their health
insurance and how pharmacies will honor the discount. The state also passed House Bill 3639
which caps EpiPens at $60 per two-pack, however this is not a discount program and the cap
may only apply to state-regulated plans.

Illinois has passed a law prohibiting price gouging of certain prescription medications, reported by the Office of Senator Koehler. Effective January, 2024, House Bill 3957 prohibits manufacturers and distributors from engaging in price gouging of essential off-patent and generic medication, making Illinois the first state in the country to do so.

Illinois will establish a state-based health insurance marketplace as well as a rate review process, reports WWTV News. Under House Bill 579, Illinois will join the eighteen other states with state-based marketplaces, offering plans sold under the Affordable Care Act with subsidies for those earnings above the Medicaid income threshold. In addition, House Bill 2296 authorizes the Illinois Department of Insurance will have the authority to modify or reject proposed premium rate increases that it determines to be unreasonable or inadequate. It also increases transparency for consumers by adding reporting requirements for insurance companies.

A report from several Illinois advocacy organizations outlines the harms of medical debt for Illinois families, particularly immigrant and Black communities, according to the Chicago Sun Times. The report includes personal stories from multiple affected residents, intended to illustrate the harms caused by hospitals charging low-income people for services when they should have been eligible for financial assistance, but were not screened.

Leaders in Illinois are working to eliminate racial healthcare disparities through a new program and cultural bias training, reports the State Journal-Register. The Illinois Department of Public Health has awarded grants totaling $3.7 million to organizations working to address health inequities, many of which were brough to the forefront by the COVID-19 pandemic. Beyond improving access to vaccines, some hospitals have adopted cultural bias training and equity, diversity and inclusion teams to help individuals better navigate the healthcare environment and work to reverse disparities. Hospitals and community groups within the state acknowledge that cultural and language barriers must be addressed to better serve their patients and ensure equitable access to care, and hope that these efforts will be led by those involved in their communities.

Illinois lawmakers passed legislation that extends continuous coverage for individuals without a source of income and lowers the eligibility age for undocumented immigrants from 55 to 42, reports mystateline.com. The new laws authorize the state to seek federal approval to allow individuals without a source of income at the time of their medical benefits redetermination to be considered for renewal. The package also expands coverage for midwifery services by adding certified professional midwives to the program.

Illinois Blue Cross Blue Shield members are having trouble finding in-network doctors due to a “ghost network,” reports WCIA. A “ghost network” refers to an insurance company’s inflated patient directory that over-promises and under-delivers on the number of providers who are actually available. While the company denies these claims, a thorough review of the company’s directory reveals that many doctors are not actually in-network, are not available, not taking new patients, and are located too far away, contrary to the directory. The complications arose after the insurance company escalated a contract dispute with Springfield Clinic and kicked all 650 of its providers off the Blue Cross Blue Shield network; patients who cannot find in-network care through the incorrect directory must shoulder high out-of-pocket costs to continue to see their providers. Those who cannot afford to do so may discontinue their care, with dire health consequences. 

A group of retired Illinois educators is suing the state over what they say is a diminishment of promised benefits, reports the Center Square. The state is reducing what taxpayers pay for retired teachers’ healthcare by around $100 million per year, starting in July 2022. The group believes that reduced state contribution would mean increased costs for retired teachers and claims that their actuary has said that the fund would be depleted in anywhere from one to four years. 

A report from the Shriver Center, in partnership with Altarum, conducted five focus groups, comprised of primarily Black Indigenous People of Color (BIPOC) individuals, to learn about Illinois residents' views on healthcare coverage. The focus groups, which consisted of 30 participants and one group held solely in Spanish, revealed that two major barriers participants experience were the cost of healthcare coverage and the complexity of choosing and enrolling into healthcare coverage. Participants expressed that what they pay out-of-pocket can sometimes be enough to cause them to choose between healthcare and basic necessities. Participants also felt that eligibility and enrollment for both Medicaid and the Marketplace were complex and confusing. They also noted the stigma attached to Medicaid and suggested that Medicaid be rebranded with different names and marketing to encourage people to enroll. 

A new law in Illinois will advance health equity by lowering costs and improving access to care for low-income and uninsured residents, reports My Journal Courier. SB 1840 amends both the Illinois Community Benefits Act and the Hospital Uninsured Patient Discount Act to decrease the maximum amount collected by uninsured patients for services rendered by a hospital from 25 percent to 15 percent of a person’s income and lowering the cost threshold for all medically necessary healthcare services that make uninsured patients eligible for discounts from $300 to $150. Among numerous other stipulations, the legislation also requires nonprofit hospitals’ community benefits plans to describe activities the hospital is undertaking to address health equity, reduce health disparities and improve community health.

A new law in Illinois aims to increase telehealth access across the state, reports the Intelligencer. The law builds upon ongoing efforts to ensure that all Illinoisans have uninterrupted telehealth access by permanently extending the payment parity requirement for mental health and substance use disorder services established by an Executive Order at the beginning of the COVID-19 pandemic. The bill also authorizes all other telehealth services to be covered through 2027.

Illinois’ inaugural round of Healthcare Transformation Collaboratives funding has allocated state funds to eight healthcare collaboratives, reports ABC 20. The goal of this influx of funding is to reorient healthcare in the state to reduce healthcare inequities, improve health outcomes, address social determinants of health and improve underserved communities’ access to quality healthcare. This program was set up following the passage of the Healthcare Transformation Collaboratives Public Act 101-650 in March 2021 that sought to develop these collaboratives to invest in underserved communities and increase access to community-based health services.

Illinois passed legislation, HB 158, to expand services from community health workers, which advocates hope will lessen health inequities, reports the State Journal Register. The bill was a part of a package of bills aimed at reducing systemic racism and inequities faced by Black, Hispanic and low-income people. The law will devote $2.5 million in fiscal year 2022 to reimburse community health workers for their services to Medicaid clients in order to better address social determinants of health. The law will also boost state funding for home-visiting services by $38 million and provide $15 million in Medicaid reimbursements for doula services for women who are pregnant and parenting. In addition, the law mandates anti-bias training for doctors and other healthcare professionals before their state licenses are renewed.

The Centers for Medicaid & Medicaid Services approved Illinois’ 1115 waiver allowing for the extension of full Medicaid benefits from 60 days to 12 months postpartum, reports the Illinois Office of the Governor. Illinois is the first state to extend full Medicaid benefits to this extent. It is hoped that this extension will strengthen continuity of care to improve health outcomes for mothers in Illinois and reduce the rate of maternal morbidity and mortality, particularly reducing the significant health disparities for Black women. Women with incomes up to 208% of the federal poverty level will have continuous Medicaid eligibility through 12 months postpartum. 

The Illinois Department of Healthcare and Family Services and Department of Insurance released a feasibility report that explores policy options to make health insurance more affordable for low- and middle-income residents in Illinois. The report notes that racial and ethnic disparities in health insurance coverage and access are reflected in people of color being more likely to be uninsured and more likely to go without care due to cost. The study included six policy options for the state to consider to achieve its goals of reducing the number of uninsured, increasing affordability of care and improving health equity: a Basic Health Program; state premium and cost-sharing subsidies; a public option plan, a Medicaid buy-in; transitioning to a state-based marketplace; and state-supported marketing and outreach.

AARP has partnered with Illinois racial justice groups to launch a “disrupt disparities” effort across the state, reports State of Reform. The multi-year effort will address the disproportionate number of older Black, Latino and Asian American seniors who have died of COVID-19 in Illinois and will work with state legislators to address this and other issues. Another crucial equity issue facing Illinoisans is access to broadband internet. According to AARP, more than a third of Black and Latino seniors in the state do not have internet access at home, leaving this vulnerable group more disconnected. Economic security is another issue AARP hopes to address, explaining that helping seniors pay off their debts will allow seniors of color to be more economically secure.

The Illinois Department of Healthcare and Family Services has proposed a new equity-centric plan to transform healthcare in the state, reports the Center Square. The plan recognizes social and structural determinants of health, as well as medical ones, and proposes ways to address them. The new plan, if implemented, will fund pilot projects and planning grants to address both healthcare and social determinants of health, emphasize collaboration between community-based organizations and one unrelated healthcare provider, and ensure that health equity is both measurable and the primary focus of each project. Pilots would fall into three collaboration categories: cross-provider partnerships, safety net hospital partnerships and critical access or distressed hospital partnerships.

Telehealth has grown rapidly in Illinois this year, in part thanks to an executive order by the state’s governor requiring insurance companies regulated by the state to cover telehealth appointments like in-person office visits, reports WBEZ. The state also expanded telehealth coverage for Medicaid and Medicare patients, and the federal government has loosened restrictions as well. However, if the pandemic ends (along with it, the governor’s order) with no legislative action, Illinois would revert to prior rules and healthcare providers would not be reimbursed for the same services at the same rates. Though experts are still unsure about the long-term impact on costs, telehealth has helped increase access without increasing patient costs for rural residents. Similarly, there is concern about lack of internet access among Black, Latinx and senior patients, which may cause them to miss out on telehealth access.

Illinois health officials are worried about increasing disparities in maternal health and mortality, with higher maternal deaths than the national average coupled with recent hospital closures, reports the Chicago Tribune. Black women across America are significantly more likely to die from pregnancy-related conditions, as well as deliver infants pre-term and lack access to prenatal care—25 percent of Black women in Chicago do not get adequate prenatal care, compared with 11 percent of white women. State health officials reviewing cases of pregnancy-related deaths have deemed about 72 percent of cases preventable. The Illinois Senate’s Public Health and Health and Human Services committees are looking into ways to shrink the maternal health disparities gap; at a recent hearing, advocates brought up opportunities to tackle these health disparities, including more implicit bias training and diversity in healthcare workers, covering doula services under Medicaid and expanding home visits and creating a birth center.

Blue Cross & Blue Shield of Illinois is piloting new programs to improve health outcomes for minorities and increase racial and ethnic diversity among medical professionals, reports Modern Healthcare. The COVID-19 pandemic has laid bare the inequities faced by people of color, which has led to the development of the Health Equity Hospital Quality Incentive Program. The program’s goal is to work closely with hospitals serving a large number of Blue Cross members in communities with people most at risk of contracting COVID-19 and, ultimately, reduce racial and ethnic disparities in care. The value-based, three-year pilot program will pay doctors more for achieving certain metrics, such as meeting maternal healthcare requirements and equitably implementing telehealth. So far, at least 10 hospitals and health systems have been invited to join. 

Starting in December 2020, low-income immigrants age 65 and older in Illinois will be eligible for Medicaid-like coverage, regardless of immigration status, reports the Chicago Tribune. Initially, between 400 and 2,000 people are expected to sign up for the program, which was part of the state budget passed earlier this year. An unpublished study by Rush University Medical Center shows the 75 to 85 age group without legal immigration status should increase elevenfold in the next 10 years. Currently, undocumented older adults are being served by a patchwork of organizations that are having to make exceptions to find solutions to help patients that would otherwise go without needed services. Advocates hope this program will provide preventive care benefits and provide a safety net that is currently inaccessible to this population. 

Illinois has renewed the Hospital Assessment Program and enacted the Health Care Affordability Act, according to WISC/WRSP. The Hospital Assessment Program has provided $450 million in additional funding for hospitals since the last assessment in 2016, with priority going to hospitals that serve large numbers of Medicaid patients. The Health Care Affordability Act eliminates and loosens requirements for Medicaid access and helps families enroll in and maintain coverage through the Children's Health Insurance Program and the ALL KIDS Act.

Most Illinois hospitals scored well in the Leapfrog Group’s latest report on patient safety, reports Illinois Radio Network. Forty-three percent of Illinois hospitals received an ‘A’ grade, which was significantly better than the national average– putting Illinois in the top 10 nationwide. According to the Leapfrog Group, hospitals with high marks tend to share certain traits, such as preventing medication errors by having the right technology in place or implementing strong staffing policies related to nursing and physicians staffing the ICU. The study considered 28 different factors when assigning grades, including policies, procedures and patient outcomes.

A majority of Illinoisans have had difficulty affording healthcare and prescription drugs in the past year, according to a new study by Consumer Healthcare Experience State Survey. According to a recent Health News Illinois article, Rep. Will Guzzardi unveiled a proposal that would create a new state board that would review data on drug prices and set new payment limits for state-regulated plans. This CHES Survey was commissioned by Protect Our Care Illinois and Altarum’s Healthcare Value Hub. 

According to a new Altarum survey, 81 percent of residents say they are “worried” or “very worried” about being able to afford some aspect of healthcare in the future, such as prescription drug costs and health insurance. WTTW reports that Illinois residents have continuously reported concern about rising healthcare costs, and how they will pay for them in the future.

A new Illinois law will cap out-of-pocket insulin costs at $100 for a 30-day supply, according to WGN9. The new legislation (SB 667) is expected to impact about 1.3 million people in the state who have diabetes and is considered an important step in lowering out-of-pocket costs for Illinois families.

The Illinois Department of Public Health will be adding maternal and child health data to its public health community map. According to the U.S. News & World Report, this data will be available to the public, and can also be used by clinicians, legislators and healthcare administrators. Data categories include low birth weight, teen birth rate, breastfeeding, prenatal care and smoking during pregnancy. The map includes numerous other topics and state officials say they're updating other categories including asthma, heart failure and pneumonia.

Consumers in Illinois have been bogged down with steep price increases when buying health insurance on the Affordable Care Act (ACA) marketplace. According to the Chicago Tribune, new proposed legislation would give the Illinois Department of Insurance the power to say “no” to certain sky-high price increases proposed by insurance companies for plans sold to individuals and small businesses. The bill wouldn’t apply to plans offered by large employers. Opponents of the bill say it does nothing to address the rising prices of healthcare that can lead to higher insurance prices, and it could limit the types of plans insurers are able to offer.

Illinois received federal approval for a state Medicaid waiver that will allow service providers to offer more care for individuals suffering from mental health and substance abuse disorders, according to an article in The Daily Northwestern. The Centers for Medicare and Medicaid Services approved the state’s application for a waiver, clearing the way for the state to use $2 billion of federally allocated Medicaid funds to invest in 10 new pilot projects that aim to improve patient experiences, including ones around mental health, violence, public safety and opioid abuse.

Psychiatry’s growing popularity as a career choice comes as the nation grapples with a stubborn shortage of psychiatrists that some fear will continue to deepen, according to an article in the Chicago Tribune. The shortage is most acute in rural areas and poor urban neighborhoods that often aren’t the first choice for in-demand doctors with plentiful options, but is also being felt across big cities as the need for mental health professionals outpaces supply. The reasons for the shortfall are varied. Greater awareness, diminished stigma and a worsening opioid crisis are driving more people to seek mental and behavioral health care. Meanwhile, nearly 60 percent of psychiatrists are over age 55, fueling a retirement wave that experts say exceeds the pipeline of new doctors who fill limited psychiatric residency slots. Low insurance reimbursement rates for psychiatrists might also be keeping some people from pursuing the specialty, or, if they do, from joining insurance networks, which keeps services out of reach of many people who can't afford to pay out of pocket.

For the fourth time in as many years, Republican Gov. Bruce Rauner has pointed to state workers’ health care as a way to save money, but this time he’s asking lawmakers to help him get it done. According to an article in the Chicago Tribune, the governor’s budget proposal calls for cutting $470 million spent on public worker health insurance, an idea unions and the courts have blocked before. Rauner wants to get the state’s portion of health care costs down to 60 percent, with employees paying the remaining 40 percent. He contends the state can’t afford to offer a more generous health plan, given Illinois’ ongoing financial troubles. Such a shift would lower the plan rankings to silver or gold, depending on how the premiums and other cost-sharing were distributed.

More than a dozen other poor Chicago neighborhoods, mostly on the city’s South and West sides, are becoming “pharmacy deserts,” according to an article in the Chicago Tribune. The term describes a community with limited access to a pharmacy, whether retail or independent. Hospital inpatient pharmacies are not typically included in these counts, as they dispense medicine only to hospitalized patients. In Chicago, research has shown most of these neighborhoods share a mix of characteristics: Their residents tend to be low-income, immigrants, and/or black and Latino. And, experts argue, given the widening scope of services many pharmacies are providing, including physicals, immunizations, drug counseling, sexually transmitted infection screening and other laboratory testing — even access to naloxone, the medication used to reverse opioid overdose — pharmacies are increasingly important pieces of the national conversation around health care, especially where health inequity already exists.

UnitedHealthcare and Oak Street Health announced they are establishing a value-based initiative for Medicare Advantage patients in 14 primary care centers in under-served communities in Illinois and two northwestern Indiana locations, according to an article in Healthcare Dive. The initiative will allow the two organizations to identify high-risk patients, help manage their chronic health conditions, effectively manage their medication needs and reduce emergency room visits and hospital re-admissions.

Advocate Health Care plans to merge with Aurora Health Care in a deal that would create the 10th largest not-for-profit system in the country, according to an article in Modern Healthcare. The Illinois-based Advocate has turned its focus to Wisconsin's largest healthcare provider. The Advocate-Aurora deal would create a health system with 27 hospitals and $10.7 billion in annual revenue.

There is a growing problem with Medicare prescription drug coverage for seniors who take high-priced specialty drugs: There is no cap on how much they pay. Each prescription drug plan is structured a little differently, but people with very high drug costs almost inevitably enter what's called the "catastrophic" phase of coverage, according to an article in the Chicago Tribune. The number of seniors who reach the catastrophic phase has almost doubled over a four-year period, to more than 1 million people in 2015. That trend was driven in part by a new generation of high-priced hepatitis C drugs, but includes high out-of-pocket costs for people taking drugs for cancer, multiple sclerosis, schizophrenia and HIV.

The Illinois Bone & Joint Institute (IBJI) team has chosen SRS Health, a leader in orthopedic HCIT solutions, to partner with them in tackling the escalating complexities of value-based care, according to a news article in GlobeNewswire. IBJI—one of the largest orthopedic specialty groups nationwide—chose SRS Health for its shared vision of engaging patients, improving care, and achieving superior outcomes. Partnering with SRS Health allows IBJI to continue to focus on delivering superior patient care without the additional burden of cumbersome data collection.

The Rauner administration has awarded bids to six insurers in his quest to overhaul a major Medicaid cost-saving initiative in Illinois, cutting the number of participating carriers in half, according to a report by Modern Healthcare. In Illinois, 12 insurers currently manage the benefits for about 63% of Medicaid recipients, though only nine carriers bid for contracts. Under Rauner's overhaul, 80% of Medicaid enrollees must choose or be assigned to a managed care plan.The new contracts are expected to save between $200 million and $300 million a year through such things as cost-cutting incentives for the insurers.

The Rauner administration has awarded bids to six insurers in a quest to overhaul a major Medicaid cost-saving initiative in Illinois which will cut the number of participating carriers in half, according to a report by Modern Healthcare. In Illinois, 12 insurers currently manage the benefits for about 63 percent of Medicaid recipients, though only 9 carriers bid for contracts. Under Rauner's overhaul, 80 percent of Medicaid enrollees must choose or be assigned to a managed care plan. The new contracts are expected to save between $200 million and $300 million a year through due to cost-cutting incentives for insurers.

Gov. Bruce Rauner announced plans to revamp the state’s Medicaid program, saying the changes could save money and improve health, according to the Chicago Tribune. The plan would expand Medicare managed care programs to 80 percent of Illinois residents on Medicaid and cut the number of insurers from 12 to 7. The plan also calls for more focus on coordinating care for patients and paying doctors and hospitals based on results rather than just for services.

The rate at which Illinois hospitals are abstaining from managed Medicaid plan networks is being referred to as a “crisis,” according to Modern Healthcare. In 2011, the state passed a law requiring 50 percent of the state’s Medicaid population to enroll in a managed care plan by 2015. Some hospitals, however, are hesitant to be in these networks, citing unresolved issues related to issues in medical management, claim payments and credentialing of physicians.

Illinois has received a million dollar grant meant to strengthen the state’s mental health coverage, according to NBC Chicago. The money will go to improving the state's data tracking and consumer analysis and supporting education and awareness for consumers on how to navigate mental health insurance coverage. 

As of Oct. 1, 2016, a new policy may put thousands of children at risk for missing vaccines, according to Crain’s Chicago Business. The Illinois Department of Public Health told doctors that the Children’s Health Insurance Plan (CHIP) would no longer cover the vaccines for low-income families for free.  Doctors will have to privately order the vaccines and wait to be reimbursed by the state.  

The University of Illinois Hospital & Health Sciences System in Chicago is testing a possible solution to “super utilizers” of healthcare  According to the Chicago Tribune. The pilot program puts chronically homeless emergency department users in subsidized housing and to provide them with case managers to help handle a range of needs.  Being a “super-utilizer” isn’t a requirement for the program but participants must be chronically homeless and have severe medical needs.  

The merger between two Chicago-area health systems is being challenged by the Federal Trade Commission, citing concerns over higher prices for insured customers, according to Modern Healthcare.

The Blue Cross and Blue Shield of Illinois and the largest independent physician practice in Chicago, DuPage Medical Group, will launch a new value-based care model, according to the HIT Consultant. The model ties payment to quality and performance measures.

Blue Cross and Blue Shield of Illinois and the largest independent physician practice in Chicago, DuPage Medical Group, will launch a new value-based care model, according to HIT Consultant. The model ties payment to quality and performance measures, and the model will provide quality and cost data to inform population health management decisions.  

Blue Cross Blue Shield, a leading insurer on the Illinois’ exchange, is seeking increases as high as 45 percent for individual health plans beginning in 2017, according to Crain’s Chicago Business. The Illinois Department of Insurance has until August 23 to review proposed hikes.

For months Advocate Healthcare and Northshore University Health system  have been seeking to combine services but have been halted by the FTC. According to Modern Healthcare, both health systems say that the FTC has no economic or factual basis to challenge the proposed merger. The FTC continues to file appeals blocking the merger.  

More than half of the states have disclosed just how much higher their healthcare premiums could be next year under the Affordable Care Act, and some of the potential increases are jaw-dropping. But Illinois residents won't get their first look at proposed 2017 premiums until Aug. 1, and that has consumer advocates frustrated, according to a Chicago Tribune report.

Advocate Health Care successfully used a combination of individual and group incentives to increase care coordination and cost-effectiveness, according to The Commonwealth Fund.  Monetary and non-monetary incentives, such as performance feedback and plaques, served as powerful motivators for physicians.

March marked the 12th month of the legislature not being able to pass a budget, according to the News-Gazette.  Because of this and previous years of underfunding, Illinois has racked up more than $2.8 billion worth of unpaid claims to its state employee group insurance program.

The Federal Trade Commission moved to block a pending merger between two of the biggest competing hospital systems on the North Shore:  Advocate Health Care and NorthShore University Healthsystem. The FTC states that the impending merger would likely result in decreased competition and ultimately harm the consumer.  Advocate and NorthShore are likely to oppose this block  and request an administrative proceeding.

Hospitals in the Chicago area are trending toward consolidation and the number of independent health systems continues to decline, according to Healthcare Dive. Independent hospitals are facing the reality that in order to survive they need to team up with bigger health systems. Hospitals are having trouble filling beds because insurance companies seem to prefer larger health  systems.

A law effective Jan. 1, 2015, promotes price transparency for consumers, according to Becker’s Hospital Review. The law states that doctors who use outside pathologists or laboratories are required to disclose the actual amount charged for the services to patients. S.B. 1630 helps to protect patients from inflated healthcare costs and surprise medical bills.