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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 CassidyBill CassidySunday shows preview: 2024 hopefuls gather at CPAC; House passes coronavirus relief; vaccine effort continues Republicans see Becerra as next target in confirmation wars Overnight Health Care: Johnson & Johnson vaccine safe, effective in FDA analysis | 3-4 million doses coming next week | White House to send out 25 million masks 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 CarperTexas snowstorm wreaks havoc on state power grid The Hill's Morning Report - Presented by TikTok - Dems rest their case; verdict on Trump this weekend No signs of demand for witnesses in Trump trial MORE (D-Del.), Todd YoungTodd Christopher YoungGraham: Trump will 'be helpful' to all Senate GOP incumbents Biden signs supply chain order after 'positive' meeting with lawmakers Republican 2024 hopefuls draw early battle lines for post-Trump era MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillThe Memo: Punish Trump or risk a repeat, warn Democrats GOP senators criticized for appearing to pay half-hearted attention to trial Hawley watches trial from visitor's gallery MORE (D-Mo.), Michael BennetMichael Farrand BennetDemocrats: Minimum wage isn't the only issue facing parliamentarian Democrats plan crackdown on rising drug costs Overnight Health Care: Biden officials announce funding to track virus variants | Senate Dems unveil public option proposal | White House: Teacher vaccinations not required for schools to reopen MORE (D-Colo.) and Chuck GrassleyChuck GrassleyGrassley to vote against Tanden nomination Grassley says he'll decide this fall whether to run in 2022 Yellen deputy Adeyemo on track for quick confirmation 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.