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 CassidyUN Security Council to meet after Turkey launches Syria offensive Trump faces growing GOP revolt on Syria To win the federal paid family leave debate, allow states to lead the way 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 CarperConservation gains in Senate bill would help all Americans Instead of raising the gas tax, stop wasting money on frivolous projects To stave off a recession, let's pass a transportation infrastructure bill MORE (D-Del.), Todd YoungTodd Christopher YoungPaul blocks vote on House-passed Syria resolution for second time Turkey sanctions face possible wall in GOP Senate Paul blocks Senate vote on House-passed Syria resolution MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillIranian attacks expose vulnerability of campaign email accounts Ex-CIA chief worries campaigns falling short on cybersecurity Ocasio-Cortez blasts NYT editor for suggesting Tlaib, Omar aren't representative of Midwest MORE (D-Mo.), Michael BennetMichael Farrand BennetThe Hill's Morning Report - Presented by Better Medicare Alliance - Trump's impeachment plea to Republicans Bennet, Udall aim to conserve 30 percent of US lands by 2030 From learning on his feet to policy director MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyMulvaney faces uncertain future after public gaffes State cites 38 people for violations in Clinton email review Lawmakers from both sides of the aisle mourn Cummings 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.