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 CassidyCongress must step up to protect Medicare home health care Ivanka Trump to meet with GOP senators to discuss paid family leave legislation Bipartisan senators ask industry for information on 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 CarperDems slam EPA plan for fighting drinking water contaminants EPA to announce PFAS chemical regulation plans by end of year Overnight Energy: Zinke joins Trump-tied lobbying firm | Senators highlight threat from invasive species | Top Republican calls for Green New Deal vote in House MORE (D-Del.), Todd YoungTodd Christopher YoungIndiana gets first national park Ivanka Trump to meet with GOP senators to discuss paid family leave legislation Trade official warns senators of obstacles to quick China deal MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillPoll: 33% of Kentucky voters approve of McConnell McCaskill: Lindsey Graham 'has lost his mind' Trey Gowdy joins Fox News as a contributor MORE (D-Mo.), Michael BennetMichael Farrand BennetDemocratic donors stuck in shopping phase of primary Overnight Health Care — Sponsored by America's 340B Hospitals — CDC blames e-cigs for rise in youth tobacco use | FDA cracks down on dietary supplements | More drug pricing hearings on tap The Hill's Morning Report - Presented by the American Academy of HIV Medicine - Next 24 hours critical for stalled funding talks MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyThe Hill's Morning Report - What to watch for as Mueller’s probe winds down Overnight Health Care — Presented by National Taxpayers Union — Drug pricing fight centers on insulin | Florida governor working with Trump to import cheaper drugs | Dems blast proposed ObamaCare changes Drug pricing fight centers on insulin 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.