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.
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 CassidyBill CassidyHillicon Valley — Presented by American Edge Project — Americans blame politicians, social media for spread of misinformation: poll Biden signs bill to strengthen K-12 school cybersecurity Senators gear up for bipartisan grilling of Facebook execs 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 CarperIs the Biden administration afraid of trade? Congress sends 30-day highway funding patch to Biden after infrastructure stalls Senate to try to pass 30-day highway bill Saturday after GOP objection MORE (D-Del.), Todd YoungTodd Christopher YoungThe unseen problems in Afghanistan How to fix the semiconductor chip shortage (it's more than manufacturing) Senate Democrats try to defuse GOP budget drama MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillEx-Rep. Akin dies at 74 Republicans may regret restricting reproductive rights Sunday shows preview: States deal with fallout of Ida; Texas abortion law takes effect MORE (D-Mo.), Michael BennetMichael Farrand BennetBuilding back better by investing in workers and communities Biden signs bill to help victims of 'Havana syndrome' Colorado remap plan creates new competitive district MORE (D-Colo.) and Chuck GrassleyChuck GrassleyFill the Eastern District of Virginia On The Money — Progressives play hard ball on Biden budget plan Hillicon Valley — Presented by LookingGlass — Congress makes technology policy moves 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.