Dem House chairman, top Republican release measure to end surprise medical bills

Dem House chairman, top Republican release measure to end surprise medical bills
© Getty Images

The Democratic and Republican leaders of the House Energy and Commerce Committee on Tuesday released a discussion draft of a measure to protect patients from getting massive, unexpected medical bills, a sign of bipartisan momentum on the issue.

The release from Energy and Commerce Chairman Frank Pallone Jr.Frank Joseph PalloneOvernight Health Care — Presented by That's Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills This week: House impeachment inquiry hits crucial stretch MORE (D-N.J.) and ranking member Greg WaldenGregory (Greg) Paul WaldenOvernight Energy: Trump rolls back Obama-era fuel efficiency standards | Controversial Keystone XL construction to proceed | Pressure mounts to close national parks amid pandemic Infrastructure bill gains new steam as coronavirus worsens Critics blast Trump mileage rollback, citing environment and health concerns MORE (R-Ore.) comes after President TrumpDonald John TrumpCampaigns face attack ad dilemma amid coronavirus crisis Outgoing inspector general says Trump fired him for carrying out his 'legal obligations' Trump hits Illinois governor after criticism: 'I hear him complaining all the time' MORE called for action on the issue last week.

ADVERTISEMENT
“Today we circulated a draft bill for review that we believe strongly protects patients and families from surprise medical bills,” Pallone and Walden said in a joint statement. “We must ensure that patients are not responsible for these outrageous bills, which is why our discussion draft removes patients from the middle.”

The measure protects patients from getting massive bills when they get emergency care from a doctor who is outside of their insurance network, with the idea being that, in an emergency, patients should not be expected to ask doctors giving them care whether they are in-network or not.

The bill then sets up a process for determining how much the insurance company needs to pay the medical providers for the out-of-network care, basing the payment rate on the usual rates in that geographic area.

Determining this payment is one of the most controversial aspects of the legislation, with insurers, doctors and hospitals all jockeying to avoid taking a financial hit.

The American Hospital Association criticized the plan on Tuesday, objecting to its methodology of setting payment rates rather than allowing medical providers and insurers to negotiate.

"We strongly oppose approaches that would impose arbitrary rates on providers," said AHA CEO Rick Pollack. 

Trump vowed to take on industry at an event at the White House last week.

“We're going to hold insurance companies and hospitals totally accountable," he said then.

 

The Senate is also working on bipartisan legislation, with Sens. 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.), Maggie HassanMargaret (Maggie) HassanDemocrats urge administration to automatically issue coronavirus checks to more people Mnuchin says Social Security recipients will automatically get coronavirus checks Lawmakers press IRS to get coronavirus checks to seniors MORE (D-N.H.) and Michael BennetMichael Farrand BennetDemocrats urge administration to automatically issue coronavirus checks to more people Five things being discussed for a new coronavirus relief bill Cyber threats spike during coronavirus pandemic MORE (D-Colo.) collaborating on a proposal in that chamber, which is expected to be released soon.

Calls for action have been sparked by stories like a teacher in Texas last year who received a $108,951 bill from the hospital after his heart attack, even though he had insurance, because the hospital was not in his insurance network.

Pallone and Walden said they are looking for feedback from stakeholders on their draft.

We look forward to receiving constructive feedback on ways to build upon our proposal, so we can advance a bipartisan solution that protects patients from costly surprise medical bills,” they said.

This story was updated at 4:49 p.m.