Bipartisan senators unveil proposal to crack down on surprise medical bills

Bipartisan senators unveil proposal to crack down on surprise medical bills
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A bipartisan group of senators is unveiling a draft measure to crack down on surprise medical bills, which they say have plagued patients with massive unexpected charges for care.

The measure would prevent a health care provider that is outside of a patient’s insurance network from charging additional costs for emergency services to patients beyond the amount usually allowed under their insurance plan.

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The insurer, not the patient, would have to pay additional charges, which are limited under the proposal.  

The bill targets situations like one that received a flood of national attention last month, when NPR and Kaiser Health News reported on a high school teacher who was charged $109,000 by the hospital that cared for his heart attack, even after his insurance had already paid $56,000.

Sen. Bill CassidyWilliam (Bill) Morgan CassidyThe Hill's Morning Report - Democratic debates: Miami nice or spice? Overnight Health Care — Campaign for Tobacco-Free Kids — Poll finds Trump vulnerable on health care in battleground states | HHS must respond to petition on abortion referral ban by Thursday | Wyden presses health officials about CBD regulations The Hill's 12:30 Report: New revelations from Trump's exclusive sit-down with The Hill MORE (R-La.), a sponsor of the bill, said the measure would mean patients don’t “get this surprise billing which is basically uncapped by anything but a sense of shame.”

Sens. Tom CarperThomas (Tom) Richard CarperHillicon Valley: Investigation finds federal agencies failed to address cyber vulnerabilities | Officials crack down on illegal robocallers | Warren offers plan to secure elections | Senators grill Google exec on 'persuasive technology' Senate investigation finds multiple federal agencies left sensitive data vulnerable to cyberattacks for past decade Senate set to bypass Iran fight amid growing tensions MORE (D-Del.), Todd YoungTodd Christopher YoungOvernight Defense: Officials brief Congress after Iran shoots down drone | Lawmakers fear 'grave situation' | Trump warns Iran | Senate votes to block Saudi arms sales | Bombshell confession at Navy SEAL's murder trial The 7 GOP senators who voted to block all or part of Trump's Saudi arms sale Senate votes to block Trump's Saudi arms sale MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillConservatives spark threat of bloody GOP primaries Congress needs to work to combat the poverty, abuse and neglect issues that children face Lobbying world MORE (D-Mo.), Michael BennetMichael Farrand BennetRules for first Democratic primary debates announced Inslee unveils plan to fight fossil fuel pollution, ban fracking The Hill's Morning Report - Crunch time arrives for 2020 Dems with debates on deck MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyThe Hill's Morning Report - Democratic debates: Miami nice or spice? Senate Finance leaders in talks on deal to limit drug price increases Million-dollar drugs pose new challenge for Congress MORE (R-Iowa) are also supporting the measure. Those lawmakers are part of a working group on health care price transparency that says it plans to put forward additional legislation as well.

“I think this is common ground in the health care debate,” Cassidy said.

“No American should have to file bankruptcy or fall into poverty as a result of a serious ailment or unexpected medical emergency,” Carper said in a statement. “The Affordable Care Act made great progress in reducing rates of medical bankruptcies, and this bipartisan discussion draft will build on that progress by protecting patients from surprise medical bills after they are treated in emergency situations or receive care from an out-of-network provider.”

The bill would also require health care providers to give written notification to patients who receive emergency care at an out-of-network facility before they receive any follow-up nonemergency care. That move is intended to warn patients before they are subject to additional costs at an out-of-network hospital.

Patients also could not be charged more for care from out-of-network doctors at an in-network hospital. That situation sometimes arises even when patients go to a hospital that is in their network, if some doctors within that hospital, for example an anesthesiologist, charge larger amounts as if they are out-of-network.

Cassidy said lawmakers will now work to refine their discussion draft before formally introducing a bill. He said he does not plan to push for consideration of the bill until the beginning of the next Congress, in January.