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 CassidyGOP senator issues stark warning to Republicans on health care Bipartisan senators offer bill to expand electric vehicle tax credit Menendez, Rubio lead Senate effort to regulate Venezuelan sanctions 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 CarperThe Hill's 12:30 Report: All eyes on Biden Biden racks up congressional endorsements Dem senators launch Environmental Justice Caucus MORE (D-Del.), Todd YoungTodd Christopher YoungA new age for tobacco — raising the age to 21 is a smart move GOP senators divided on Trump trade pushback Menendez, Rubio lead Senate effort to regulate Venezuelan sanctions MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillBig Dem names show little interest in Senate Gillibrand, Grassley reintroduce campus sexual assault bill Endorsements? Biden can't count on a flood from the Senate MORE (D-Mo.), Michael BennetMichael Farrand BennetMichael Bennet declared cancer-free, paving way for possible 2020 run License to discriminate: Religious exemption laws are trampling rights in rural America Only four Dem senators have endorsed 2020 candidates MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyRepublican senators request briefing on DOJ 'spying' probe House to vote on bipartisan retirement bill in May Sanders, Klobuchar among five most popular senators: poll 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.