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Senators ask CBO to review options for preventing surprise medical bills

Senators ask CBO to review options for preventing surprise medical bills
© Greg Nash

The leaders of the Senate Health Committee are asking the Congressional Budget Office (CBO) to analyze possible options for protecting patients from getting hit with massive, unexpected medical bills.

Chairman Lamar AlexanderLamar AlexanderAuthorities link ex-Tennessee governor to killing of Jimmy Hoffa associate The Republicans' deep dive into nativism Senate GOP faces retirement brain drain MORE (R-Tenn.) and Sen. Patty MurrayPatricia (Patty) Lynn MurraySenate GOP blocks bill to combat gender pay gap OVERNIGHT ENERGY: Biden suspends Arctic oil leases issued under Trump |  Experts warn US needs to better prepare for hurricane season | Progressives set sights on Civilian Climate Corps Progressives set sights on Civilian Climate Corps program: exclusive MORE (Wash.), the panel's top Democrat, sent options for analysis to the CBO, according to Senate aides.

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It's the latest sign that lawmakers are serious about moving forward on legislation to address so-called surprise medical bills, a rare issue where there could be bipartisan action this year.  

The goal is to stop instances like a viral story last year of a teacher in Texas who got a $108,951 bill from the hospital after his heart attack because the hospital was not in his insurance network.

Alexander and Murray’s action is preliminary and lawmakers have not decided on the details of any legislation yet.

The two are working in consultation with a bipartisan group of senators that is in discussions on the issue, which includes Sens. Bill CassidyBill CassidyBipartisan lawmakers want Biden to take tougher action on Nicaragua The Hill's 12:30 Report - Presented by Facebook - Sights and sounds from Biden's UK visit Democrats wary of emerging bipartisan infrastructure deal MORE (R-La.), Michael BennetMichael Farrand BennetSenate panel advances nominations for key Treasury positions Democrats blast Biden climate adviser over infrastructure remarks Colorado lawmakers invite Harris to tour state's space industry MORE (D-Colo.), and Maggie HassanMargaret (Maggie) HassanProgressives want to tighten screws beyond Manchin and Sinema OVERNIGHT ENERGY: Biden ends infrastructure talks with key Republican | Colonial Pipeline CEO grilled over ransomware attack | Texas gov signs bills to improve power grid after winter storm Colonial Pipeline CEO grilled over ransomware attack MORE (D-N.H.), a Senate aide said.

Alexander and Murray are known as two of the best bipartisan dealmakers in the Senate. The pair tried, ultimately unsuccessfully, in 2017 and 2018 to pass an agreement to stabilize ObamaCare.

Since then, Alexander has said he wants to move on from debating the politically charged health care law and instead focus more broadly on lowering health care costs, including countering surprise medical bills.

Lawmakers in both parties and industry groups largely agree that patients should be protected from getting massive, unexpected medical bills.

The debate is over how to determine how much the insurer will pay to the doctor or hospital.

Insurers, doctors and hospitals are jockeying over those details, fearful of taking a financial hit in the legislation.

Alexander and Murray sent a range of possible options on those details to the CBO.

One option is to have an arbitrator determine how much the insurer pays the doctor or hospital. Another option is to set a payment rate based off a percentage of Medicare’s payment rates or something similar. A third option is to require hospitals to send a single bill to the insurer, preventing doctors within the hospital from independently charging the insurer at much higher rates.

Those three options are not the only options that Alexander and Murray sent to the CBO, though.

“People go to the emergency room and they suddenly are surprised a few weeks later with a bill for $3,000 from an out-of-network doctor,” Alexander told reporters in January. “We don’t want that happening, so one way or the other I expect to see that addressed in the next several months.”