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 CassidyBig Pharma looks to stem losses after trade deal defeat Trump trade deal faces uncertain Senate timeline On The Money: Senate panel advances Trump's new NAFTA despite GOP gripes | Trade deficit falls to three-year low | Senate confirms Trump pick for small business chief 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 CarperDemocrats ask if US citizens were detained at border checkpoints due to Iranian national origin Democrats, greens blast Trump rollback of major environmental law EPA employees push 'bill of rights' to protect scientific integrity MORE (D-Del.), Todd YoungTodd Christopher YoungIran resolution supporters fear impeachment will put it on back burner Senate GOP's campaign arm hauls in million in 2019 Sens. Kaine, Lee: 'We should not be at war with Iran unless Congress authorizes it' MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillThe most expensive congressional races of the last decade McCaskill: 'Mitch McConnell has presided over absolutely destroying Senate norms' Claire McCaskill: Young girls 'are now aspiring' to be like Warren, Klobuchar after debate MORE (D-Mo.), Michael BennetMichael Farrand BennetSanders to headline Iowa event amid impeachment trial On The Money — Presented by Wells Fargo — Sanders defends vote against USMCA | China sees weakest growth in 29 years | Warren praises IRS move on student loans Klobuchar on missing campaigning for impeachment: 'I can do two things at once' MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleySenate begins preparations for Trump trial Big Pharma looks to stem losses after trade deal defeat Appeals court skeptical of Trump rule on TV drug ads 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.