Congress to the res­cue?

Modern Healthcare - - News -

Sur­prise billing is one of the few ar­eas that could see bi­par­ti­san ac­tion in Wash­ing­ton, D.C. Last year, law­mak­ers on both sides of the aisle in­tro­duced bills to curb or at least min­i­mize the im­pact of sur­prise bills.

Pro­tect­ing Pa­tients from Sur­prise Med­i­cal Bills Act would:

• Limit pa­tient cost-shar­ing to the amount they’d owe an in-net­work provider

• Es­tab­lish pay­ment stan­dards de­tail­ing what in­sur­ers would owe providers in those cases

• Pro­hibit bal­ance billing by providers

• Once a pa­tient is sta­bi­lized in an out-of-net­work emer­gency room, the provider would have to no­tify them of the po­ten­tial for higher costs if they re­main in the facility

No More Sur­prise Med­i­cal Bills Act would:

• Re­strict charges to in-net­work lev­els

• Re­quire in­sur­ers to count the cost-shar­ing amount for sur­prise out-of-net­work bills to­ward in-net­work de­ductible and out-of-pocket lim­its

• Es­tab­lish bind­ing ar­bi­tra­tion in cases where in­sur­ers and providers can’t reach agree­ment

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.