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 AlexanderAndrew (Lamar) Lamar AlexanderSenate Health Committee advances bipartisan package to lower health costs Senate Finance leaders in talks on deal to limit drug price increases Overnight Health Care — Campaign for Tobacco-Free Kids — Poll finds Trump vulnerable on health care in battleground states | HHS must respond to petition on abortion referral ban by Thursday | Wyden presses health officials about CBD regulations MORE (R-Tenn.) and Sen. Patty MurrayPatricia (Patty) Lynn MurraySenate Health Committee advances bipartisan package to lower health costs Overnight Health Care: Trump officials defend changes to family planning program | Senators unveil bipartisan package on health costs | Democrats pass T spending bill with HHS funds Chris Murphy may oppose bipartisan health bill unless it addresses ObamaCare 'sabotage' 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 CassidyWilliam (Bill) Morgan CassidyThe Hill's Morning Report - Democratic debates: Miami nice or spice? Overnight Health Care — Campaign for Tobacco-Free Kids — Poll finds Trump vulnerable on health care in battleground states | HHS must respond to petition on abortion referral ban by Thursday | Wyden presses health officials about CBD regulations The Hill's 12:30 Report: New revelations from Trump's exclusive sit-down with The Hill MORE (R-La.), Michael BennetMichael Farrand Bennet2020 Democrats spar over socialism ahead of first debate The Hill's 12:30 Report: Anticipation high ahead of first debate Where 2020 Democrats stand in betting markets ahead of first debate MORE (D-Colo.), and Maggie HassanMargaret (Maggie) HassanSecond ex-Senate staffer charged in aiding doxxing of GOP senators Key endorsements: A who's who in early states Overnight Health Care: Poll finds most Americans misunderstand scope of 'Medicare for All' | Planned Parenthood chief readies for 2020 | Drugmakers' lawsuit ramps up fight with Trump 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.”