The Chairman and Ranking Member of the House Energy and Commerce Committee recently released a bipartisan discussion draft for legislation that would address the issue of surprise out-of-network medical bills. Surprise medical bills, also known as “balance bills,” arise when patients visit a hospital or health care provider that they think is in their insurance network, but are then treated by a doctor, specialist, or technician who is out-of-network. The patient is then billed directly by the provider for an unexpectedly expensive out-of-network service.
The House’s discussion draft would eliminate the practice of surprise billing for both emergency and non-emergency services across all types of insurance plans, including commercial and employer-sponsored insurance. This draft legislation would eliminate surprise medical bills by requiring health plans to treat the out-of-network service as an in-network service, setting a minimum amount that the plan must pay providers, and prohibiting out-of-network providers from directly billing any remaining balances to patients. This would ensure that patients do not receive surprise medical bills as a result of unintentionally receiving care from an out-of-network provider.
Health Affairs has published a thorough analysis of the discussion draft. Keep reading.