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 Year Ahead: Drug pricing efforts to test bipartisanship GOP balks at Trump drug pricing plan Overnight Defense: Senate rebukes Trump with Yemen vote | Mattis, Pompeo briefing fails to quell Senate concerns with Saudis | Graham demands CIA briefing on Khashoggi | Pentagon identifies three troops killed in Afghanistan 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 CarperOvernight Health Care — Sponsored by Amgen — ObamaCare signups lag behind last year despite recent surge | Drug company offers cheaper opioid overdose treatment after hiking price 600 percent | CDC calls fentanyl deadliest drug in US Drug company to offer cheaper opioid overdose treatment after hiking price 600 percent Overnight Energy: Trump adviser Kudlow seeks end to electric car, renewable energy credits | Shell to pay execs based on carbon reduction | Justices reject greens' border wall lawsuit MORE (D-Del.), Todd YoungTodd Christopher YoungOvernight Defense: Senate bucks Trump with Yemen war vote, resolution calling crown prince 'responsible' for Khashoggi killing | House briefing on Saudi Arabia fails to move needle | Inhofe casts doubt on Space Force GOP-controlled Senate breaks with Trump on Saudi vote Overnight Defense: Senate moves toward vote on bill ending support for Saudi war | House GOP blocks Yemen war votes for rest of year | Trump throws uncertainty into Pentagon budget | Key Dem to leave transgender troop ban to courts MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillMcCaskill: 'Too many embarrassing uncles' in the Senate FEC votes to allow lawmakers to use campaign funds for personal cybersecurity McCaskil 'not sure' Sanders, Harris, Warren can win Missouri in 2020 MORE (D-Mo.), Michael BennetMichael Farrand BennetWould-be 2020 Dem candidates head for the exits The Hill's Morning Report — Presented by T-Mobile — What the Michael Flynn news means California primary threatens to change 2020 game for Dems MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyTop security officials issue stark warning of Chinese espionage efforts Lame-duck Congress should pass First Step Act The Hill's Morning Report — Takeaways from the battle royal in the Oval Office 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.