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 CassidyOvernight Health Care — Presented by Campaign for Accountability — House passes drug pricing bills amid ObamaCare row | Senate Republicans running away from Alabama abortion law | Ocasio-Cortez confronts CEO over K drug price tag Bipartisan senators unveil measure to end surprise medical bills Work on surprise medical bills goes into overdrive 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 CarperOvernight Energy: EPA watchdog finds Pruitt spent 4K on 'excessive' travel | Agency defends Pruitt expenses | Lawmakers push EPA to recover money | Inslee proposes spending T for green jobs Lawmakers take EPA head to task for refusing to demand Pruitt repay travel expenses Dems request investigation of lobbyist-turned-EPA employee who met with former boss MORE (D-Del.), Todd YoungTodd Christopher YoungBipartisan senators unveil measure to end surprise medical bills Pence, McConnell eulogize Sen. Richard Lugar On The Money: GOP angst grows over Trump's trade war | Trump promises help for 'Patriot Farmers' | Markets rebound | CBO founding director Alice Rivlin dies | Senate to vote on disaster aid bill next week 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 BennetMomentum builds behind push to pass laws enshrining abortion rights The Hill's Morning Report — Presented by Pass USMCA Coalition — Trump: GOP has `clear contrast' with Dems on immigration Bullock opens Iowa bid pitching rural credentials MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyOvernight Defense: Trump rails against media coverage | Calls reporting on Iran tensions 'highly inaccurate' | GOP senator blocking Trump pick for Turkey ambassador | Defense bill markup next week Trump reaches deal to lift steel, aluminum tariffs on Mexico, Canada Top GOP senator blocking Trump's pick for Turkey ambassador 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.