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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 CassidyWilliam (Bill) Morgan CassidyTrump signs bills banning drug pricing 'gag clauses' Dem ad accuses Heller of 'lying' about record on pre-existing conditions GOP senator suggests criminal referral for third Kavanaugh accuser's 'apparently false affidavit' 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 CarperTrump poised to sign bipartisan water infrastructure bill Overnight Health Care — Presented by the Coalition for Affordable Prescription Drugs — Senators face Wednesday vote on Trump health plans rule | Trump officials plan downtime for ObamaCare website | Lawmakers push for action on reducing maternal deaths Bipartisan group of senators ask Trump to increase focus on maternal deaths MORE (D-Del.), Todd YoungTodd Christopher YoungSaudis 'obscuring' journalist disappearance, GOP senator tells Hill.TV Overnight Defense — Presented by The Embassy of the United Arab Emirates — Missing journalist strains US-Saudi ties | Senators push Trump to open investigation | Trump speaks with Saudi officials | New questions over support for Saudi coalition in Yemen Senators demand answers on Trump administration backing of Saudi coalition in Yemen MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillGOP Senate candidate: Kavanaugh 'debacle' 'hugely motivating' to Missouri voters Democrats hold fading odds of winning Senate this November Cornyn: 'All the money in the world' won't help O'Rourke win Texas MORE (D-Mo.), Michael BennetMichael Farrand BennetEagles player sits out national anthem Trump administration denied it has ‘secret’ committee seeking negative information on marijuana: report Overnight Health Care: Senators target surprise medical bills | Group looks to allow Medicaid funds for substance abuse programs | FDA launches anti-vaping campaign for teens MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyClinton's security clearance withdrawn at her request Kavanaugh tensions linger after bitter fight Senate heads home to campaign after deal on Trump nominees 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.