Congress urged to do something about ‘surprise’ medical bills
one night of had been subcontracted to a treatment third-party provider, which in the hos- was not part of their insur
WASHINGTON — Bemoanpital’s Newance network. ing a health insurance sysborn Inten“The bill was not itemtem that one lawmaker said sive Care ized at all,” Wilkes said. “It is “really messed up,” a U.S. Unit — and was just a dollar amount.”
House panel was urged last then a sur“I think this is nuts,” said week to find a legislative soluprise bill. Rep. Greg Walden, R-Ore. tion to help prevent consum“Opening “This is going on every day ers from being hit with large the mail, we found a bill for in America.” surprise medical bills, espe- $50,000 for Thomas’s stay While doctors who testicially ones that arrive after in the NICU,” said patient fied before the House Energy hospital stays or emergency advocate Sonji Wilkes. “My and Commerce Committee emergency room treatment. room visits, because the ser- husband and I were dumb- on Wednesday said they obvi“In a medical emergency, vices were considered “out- founded. We had been in ously don’t like the endless getting treatment as soon of-network” for insurance an in-network facility. How stream of stories about suras possible is the number coverage. could we possibly be respon- prise bills, they argued their one priority — not verifying
One woman described sible for that amount?” focus is on care, not the intri- which providers are in-nethow the discovery that her Wilkes told lawmakers that cate details of an individu- work, figuring out how much newborn son had hemophilia it turned out the NICU was al’s health insurance plan, your deductible is, or worafter a circumcision led to not run by the hospital but especially when it comes to rying how much treatment will cost, said Dr. Vidor Fried- man.
“I h appen to work in Orlando, Florida, at the hospital closest to Disney World,” Friedman added. “Forty percent of my patients come from out of state — so 40% of my patients are outof-network.”
Lawmakers have intro- duced what’s being called the “No Surprises Act” in Congress, a bipartisan effort to cut down on surprise medical bills.
The main goal of the plan is to hold patients harmless — especially in emergency situations — and increase the amount of transparency governing how patients are billed for medical services.
“Our number one recommendation is not to wait,” said Claire McAndrew with Families USA. “This legislation must pass this year.”
Studies have shown that about 20% of visits to an emergency room draw a surprise medical bill, but there is also evidence that inpatient hospital care can bring billing surprises as well, along with air ambulance services.
“We all expect to receive medical bills, but the surprise in a surprise bill is a shock that can amount to more than people have in their savings account,” said Rep. Anna Eshoo, D-Calif.