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 Cassidy2 Republican senators introduce resolution to label antifa as domestic terrorists Finding a path forward to end surprise medical billing Liberal think tank: GOP paid parental leave proposals are too narrow 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 CarperFighting the opioid epidemic: Congress can't just pass laws, but must also push to enforce them Overnight Energy: Scientists flee USDA as research agencies move to Kansas City area | Watchdog finds EPA skirted rules to put industry reps on boards | New rule to limit ability to appeal pollution permits Watchdog finds EPA skirted rules when appointing industry leaders to science boards MORE (D-Del.), Todd YoungTodd Christopher YoungHouse votes to block Trump's Saudi arms sale Republicans scramble to contain Trump fallout GOP chairman introduces bill to force 'comprehensive review' of US-Saudi relationship MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillTrump nominees meet fiercest opposition from Warren, Sanders, Gillibrand Feds allow campaigns to accept discounted cybersecurity services GOP frets over nightmare scenario for Senate primaries MORE (D-Mo.), Michael BennetMichael Farrand BennetDemocratic strategist predicts most 2020 candidates will drop out in late fall The Hill's 12:30 Report: Trump hits media over 'send her back' coverage The Hill's Campaign Report: Second debate lineups set up high-profile clash MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyScandal in Puerto Rico threatens chance at statehood Poll: McConnell is most unpopular senator Democrat: Treasury 'acknowledged the unprecedented process' in Trump tax return rejection 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.