Bipartisan senators unveil proposal to crack down on surprise medical bills

Bipartisan senators unveil proposal to crack down on surprise medical bills
© Getty Images

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.

ADVERTISEMENT
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 CassidyThis bipartisan plan is the most progressive approach to paid parental leave Obstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills 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 CarperLobbying World Overnight Energy: BLM staff face choice of relocation or resignation as agency moves | Trump says he's 'very much into climate' | EPA rule would expand limits on scientific studies Democrats give Warren's 'Medicare for All' plan the cold shoulder MORE (D-Del.), Todd YoungTodd Christopher YoungGOP senators unveil bill to expand 'opportunity zone' reporting requirements Statesmen seek bipartisan solutions to big challenges The Hill's 12:30 Report: Trump says he is fighting testimony to protect presidency MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillGinsburg health scare raises prospect of election year Supreme Court battle MSNBC's McCaskill: Trump used 'his fat thumbs' to try to intimidate Yovanovitch GOP senator rips into Pelosi at Trump rally: 'It must suck to be that dumb' MORE (D-Mo.), Michael BennetMichael Farrand BennetYang: 2020 rivals in Senate should be able to campaign amid impeachment Trump trade deal likely to sow division in Democratic presidential field Schumer to colleagues running for White House: Impeachment comes first MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyGrassley urges White House to help farmers in year-end tax talks The Hill's Morning Report — Sponsored by AdvaMed — House panel delays impeachment vote until Friday The Hill's Morning Report - Sponsored by AdvaMed - House panel expected to approve impeachment articles Thursday 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.