Bipartisan Surprise Medical Bills Legislation in the Works

Members of Congress are working together, across the aisle, to draft bipartisan surprise medical bills legislation, hoping to protect patients from unexpected charges after receiving medical care.

Reps. Frank Pallone and Greg Walden–respectively, the top Democrat and Republican sitting on the House Energy and Commerce Committees–reportedly released a draft of new legislation that would help protect against surprise billing, stopping the practice both in the cases of an out-of-network hospital and out-of-network providers within an in-network hospital.

“The Energy and Commerce draft is the strongest proposal at the federal level to date,” Loren Adler, the associate director of the USC-Brookings Schaeffer Initiative for Health Policy, told Vox. “It clearly eliminates the problem of surprise billing in both emergency and non-emergency situations.”

Lawmakers from both major parties, as well as the current administration, all agree that surprise medical billing needs to come to an end.

What Are Surprise Medical Bills?

The phenomenon of surprise medical bills—unexpected charges after a hospital or doctor visit, even after you think the bill has been covered by insurance, or fees that are way higher than expected—can have a huge financial impact on Americans and their families.

Typically, surprise medical bills happen when a patient is treated by an out-of-network provider without their knowledge. Even if a patient is treated at hospital that is in their insurance network, they may be treated by a doctor or specialist that is out-of-network, which later lands them with surprise medical bills.

Unexpected expenses are bad enough, but to make matters worse, out-of-network care generally costs much more than in-network treatment. For these reasons, surprise medical bills can be financially devastating, with thousands of dollars in unexpected charges.

Unfortunately, surprise medical bills are all too common. According to CBS News, four out of 10 people surveyed reported being hit with a surprise medical bill from a hospital, lab, or doctor sometime in the past year.

Surprise Medical Bills Legislation

The Pallone and Walden bill draft addresses the problem of surprise medical billing in a few ways.

First, health insurers would be required to treat any emergency out-of-network care as in-network, eliminating the problem of surprise bills from a medical emergency.

The bill also prohibits “balance billing”—that is, when a health care provided charges a patient the difference between the price set for the service and the price the health insurer will pay.

Lastly, insurers would be required to make a minimum payment to out-of-network providers based on what they would pay to nearby in-network providers.

This bill is still in the works (as well as other versions of surprise medical billing legislation in Congress, the Senate, and in individual states) and legislators still need to work out certain problems. For instance, surprise billing is not prohibited for ambulances—which can be extremely costly. The lawmakers are still looking for ways to address this problem in future versions of their bill.

Filing a Surprise Medical Bill Lawsuit

Changes to surprise medical bills legislation will be helpful, but there are patients who are feeling the financial effects of these unexpected charges now.

For these patients, there is a recourse: turning to litigation. If you have been hit with a surprise medical bill from a hospital, doctor, or lab, but were treated at an in-network hospital, you may be able to join a class action lawsuit.

Pursuing litigation can feel overwhelming, so Top Class Actions has done some of the work for you by connecting you with an experienced attorney. An attorney can help determine if you have a claim, navigate the complexities of litigation, and maximize your compensation.

Join a Free Surprise Medical Bill Class Action Lawsuit Investigation

If you were hit with a surprise medical bill from an out-of-network doctor at an in-network hospital, you may be entitled to compensation.

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This article is not legal advice. It is presented 
for informational purposes only.