Lawmakers Commit to Pushing Legislation that Stops Surprise Medical Billing

House and Senate Health Committee Leaders announced that they would push forward bipartisan legislation that seeks to end surprise medical bills and lower prescription drug and other medical costs by requiring greater transparency from medical professionals.

“Surprise medical bills are the outrageous result of a broken system that takes advantage of vulnerable patients. Last summer, our two committees advanced bipartisan solutions to protect patients from these bills, and in December we announced a bipartisan, bicameral agreement to put an end to this egregious billing practice,” House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-N.J.), Ranking Member Greg Walden (R-Ore.), Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) said in a statement Feb. 7.

In December 2019, the House Energy and Commerce and Senate Health Committee leaders first announced a bipartisan, bicameral agreement (“Lower Health Care Costs Act of 2019”) that would protect consumers medical rights and end opaque billing practices.

The committee leaders broadened an investigation into surprise billing practices of doctors staffing companies and leading insurers. In letters to top insurance companies, the congressmen requested “information and documents pertaining to the billing policies and practices of physician staffing companies and insurers when a patient receives care from an out-of-network provider at an in-network facility, which too often results in a surprise medical bill.”

Investigations by the American Enterprise Institute and the Brookings Institution were referenced in those letters, showing that surprise bills are frequently associated with services provided by an out-of-network emergency physician or supplementary clinician—“such as a radiologist, anesthesiologist, pathologist, hospitalist, or assistant consulting surgeon—at an in-network health facility.”

Many of the services that are frequently related to surprise bills are areas where hospitals have outsourced patient care.

The lawmakers pushed the companies for answers “as to the policies and practices when a provider is not in-network with a patients insurance company, including the policies as they relate to sending surprise bills, and the relationship with certain private equity firms.”

One of the main goals of the bill is to protect patients and their families from the devastating financial toll a sRead More – Source