WASHINGTON, DC - When American patients and their families receive medical care, they shouldn’t have to lie awake at night worrying about the hidden fees or unexpected bills to come. That’s why the House Committee on Ways and Means has offered its solution to end surprise medical bills once and for all.
Earlier this afternoon, the Committee unanimously voice voted legislation from Chairman Richard E. Neal (D-MA) and Ranking Member Kevin Brady (R-TX) that would protect patients from surprise medical bills, boost transparency, and reduce patients’ health care costs.
Professional health and medical groups from across the country support the Committee’s bipartisan legislation, the Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826). Some examples include:
American Hospital Association:
“The legislation prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and does not allow patients to be charged more than the in-network cost-sharing amount. …enables providers and health plans an opportunity to directly negotiate fair and appropriate reimbursement, thereby minimizing the government’s role in the process and reducing the risk that a federal legislative approach addressing surprise medical billing could cause wider market distortions."
American Medical Association:
“We support the underlying mechanism for resolving these disputes, including the eligibility of all disputed claims for negotiation and mediation. We also appreciate that the mediator must consider a wide range of supporting information submitted by physicians in rendering a final determination."
Federation of American Hospitals:
"The plan... provides certainty for patients while enabling the health care community to settle payments without unnecessary rate setting. We are pleased to see this progress on surprise billing legislation and hope that the Congress can unify around this commonsense solution."
America’s Essential Hospitals:
“We thank [the] Committee on Ways and Means... for their leadership in reaching a bipartisan agreement that respects negotiations between hospitals and health plans. We also appreciate that the proposal recognizes the need to consider various types of providers and services when setting appropriate payment levels."
Association of American Medical Colleges:
“In addition to protecting patients and their families, the Committee’s approach promotes a fair resolution process for billing disputes between providers and insurers."
American College of Emergency Physicians:
“ACEP supports this bill and is encouraged that the Ways and Means Committee recognizes that a mediation process with no qualifying threshold must be part of a reasonable congressional solution to surprise bills."
AARP:
“We are supportive of enacting safeguards to protect consumers against surprise bills from non-network providers who provide services without the consumer’s knowledge or consent in an otherwise in-network setting, and we believe this bill takes steps in the right direction to address the problem of surprise billing."
Academic Medical Centers:
“The Ways and Means proposal creates a unique pathway to protect patients from surprise billing while creating a fair and streamlined system to resolve disputes between providers and health insurance plans."
Catholic Health Association:
“CHA strongly supports protecting patients from surprise bills. We appreciate that the Consumer Protections Against Surprise Medical Bills Act of 2020 accomplishes this goal by including new safeguards in law. Patients should not be subject to financial consequences when they have unexpected and unavoidable encounters with out-of-network health care facilities and providers. They also should be removed from any subsequent payment negotiations between facilities, providers and insurers."
Massachusetts Health & Hospital Association:
“The bi-partisan Ways & Means proposal provides important protections and transparency for patients while bringing insurers and care providers together to negotiate without undue government interference in private contracts. It correctly takes patients out of the middle of surprise billing disputes and holds insurers accountable for their responsibilities in these situations. This approach is the first fair and balanced solution we have seen emanate from Congress."
California Hospital Association:
“We appreciate the House Ways and Means Committee’s commitment to protect patients and your collaborative efforts to craft the Consumer Protection Against Surprise Medical Bills. In addition to protecting patients, we are pleased that the bill encourages providers and payers to continue private negotiations to resolve out-of-network bills. These negotiations are critical to the intricate balance between hospitals and insurers, and to preserving access to care for Californians."
Greater New York Hospitals Association:
“In addition to protecting consumers, the House Ways and Means Committee’s surprise billing legislation does not mandate a harmful benchmark payment rate. It is therefore a significant improvement over the other surprise billing proposals released to date."
The Oregon Association of Hospitals and Health Systems:
“In our view, your bill is the most effective approach to protect patients from surprise medical bills introduced to date. It will hold patients harmless in emergency situations or when they cannot reasonably choose their provider and establishes a fair, appropriate process for reimbursing out-of-network providers for services they provide in in-network facilities."
The American Heart Association, the American Kidney Fund, the American Lung Association, the Cystic Fibrosis Foundation, the Epilepsy Foundation, the Hemophilia Federation of America, the Leukemia & Lymphoma Society, the Muscular Dystrophy Association, the National Health Council, the National Hemophilia Foundation, the National Multiple Sclerosis Society, the National Organization for Rare Disorders, the National Patient Advocate Foundation, and the National Psoriasis Foundation:
“Our organizations appreciate the House Ways & Means Committee’s actions today to markup the Consumer Protections Against Surprise Medical Bills Act, intended to prevent patients from facing surprise medical bills. This legislation includes critical patient protections and transparency requirements that help ensure that patients have access to accurate provider directories and are shielded from unfair billing practices."
The nonpartisan Congressional Budget Office estimates the Committee’s bipartisan bill would reduce premiums for patients, lowering health care costs while putting an end to surprise medical bills.
