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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 CassidyCentrists gain foothold in infrastructure talks; cyber attacks at center of Biden-Putin meeting Centrists gain leverage over progressives in Senate infrastructure battle Overnight Health Care: Takeaways on the Supreme Court's Obamacare decision | COVID-19 cost 5.5 million years of American life | Biden administration investing billions in antiviral pills for COVID-19 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 CarperSenate confirms Radhika Fox to lead EPA's water office Rick Scott threatens to delay national security nominees until Biden visits border Senate panel unanimously advances key Biden cyber nominees MORE (D-Del.), Todd YoungTodd Christopher YoungCentrists gain foothold in infrastructure talks; cyber attacks at center of Biden-Putin meeting Centrists gain leverage over progressives in Senate infrastructure battle The Senate just passed the next Apollo program MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillThe Hill's Morning Report - Presented by Uber - Jan. 6 commission vote delayed; infrastructure debate lingers into June Missouri Republicans move to block Greitens in key Senate race Democratic Kansas City, Mo., mayor eyes Senate run MORE (D-Mo.), Michael BennetMichael Farrand BennetSchumer vows to only pass infrastructure package that is 'a strong, bold climate bill' Past criticism of Trump becomes potent weapon in GOP primaries Hillicon Valley: Big Tech critic Lina Khan named chair of the FTC | Lawmakers urge Biden to be tough on cyber during summit with Putin | TSA working on additional security regulations following Colonial Pipeline hack MORE (D-Colo.) and Chuck GrassleyChuck Grassley 64 percent of Iowans say 'time for someone else' to hold Grassley's Senate seat: poll Five takeaways on the Supreme Court's Obamacare decision On The Money: Yellen, Powell brush off inflation fears | Fed keeps rates steady, upgrades growth projections 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.