Bipartisan senators unveil proposal to crack down on surprise medical bills

Bipartisan senators unveil proposal to crack down on surprise medical bills
© Getty Images

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.

ADVERTISEMENT
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 CassidyTensions boil over on Senate floor amid coronavirus debate  Overnight Energy: Democratic lawmakers seek emissions reductions in airline bailout | House Dems warn Trump against oil industry bailout | GOP senators ask Saudis to stabilize oil market GOP senators ask Saudis to stabilize oil market 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 CarperDemocrat calls on EPA to withdraw 'secret science' rule Blame game heats up as Senate motion fails Democratic senators, attorneys general slam proposal to roll back protections for birds MORE (D-Del.), Todd YoungTodd Christopher YoungRand Paul's coronavirus diagnosis sends shockwaves through Senate GOP lukewarm on talk of airline bailout Trump, GOP scramble to keep economy from derailing MORE (R-Ind.), Claire McCaskillClaire Conner McCaskillGOP lukewarm on talk of airline bailout Claire McCaskill: Ron Johnson is an 'embarrassing tool' To winnow primary field, Obama and other Democrats must speak out  MORE (D-Mo.), Michael BennetMichael Farrand BennetDemocrats eye additional relief checks for coronavirus Hillicon Valley: Facebook launches portal for coronavirus information | EU sees spike in Russian misinformation on outbreak | Senate Dem bill would encourage mail-in voting | Lawmakers question safety of Google virus website We need a massive economic response to counter the threat of the coronavirus MORE (D-Colo.) and Chuck GrassleyCharles (Chuck) Ernest GrassleyDemocrats eye additional relief checks for coronavirus Coronavirus pushes GOP's Biden-Burisma probe to back burner Lobbying blitz yields wins for airlines, corporations, banks, unions 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.