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 CassidyFrom a Republican donor to Senate GOP: Remove marriage penalty or risk alienating voters Stimulus checks debate now focuses on size, eligibility On The Money: GDP shrinks by record amount in second quarter amid virus lockdowns | Jobless claims rise for second straight week | McConnell tees up fight on unemployment benefits 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 CarperNot a pretty picture: Money laundering and America's art market OVERNIGHT ENERGY: Trump's pitch to Maine lobstermen falls flat | White House pushed to release documents on projects expedited due to coronavirus | Trump faces another challenge to rewrite of bedrock environmental law NEPA White House pushed to release documents on projects expedited due to coronavirus MORE (D-Del.), Todd YoungTodd Christopher YoungRepublicans dismiss Trump proposal to delay election Senate GOP posts M quarter haul as candidates, Trump struggle A renewed emphasis on research and development funding is needed from the government MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillDemocratic-linked group runs ads in Kansas GOP Senate primary Trump mocked for low attendance at rally Missouri county issues travel advisory for Lake of the Ozarks after Memorial Day parties MORE (D-Mo.), Michael BennetMichael Farrand BennetExpanding our health force can save lives and create jobs simultaneously How Congress is preventing a Medicare bankruptcy during COVID-19 Tom Cotton rips NY Times for Chinese scientist op-ed criticizing US coronavirus response MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyMcConnell goes hands-off on coronavirus relief bill GOP chairmen hit back at accusation they are spreading disinformation with Biden probe On The Money: Unemployment debate sparks GOP divisions | Pandemic reveals flaws of unemployment insurance programs | Survey finds nearly one-third of rehired workers laid off again 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.