Groups Call on Congress to End Surprise Billing
Written by Editor   
Tuesday, December 11, 2018 12:08 PM

Nine groups representing health insurers, employers and consumers have called for federal legislation to protect patients from surprise medical bills from out-of-network providers.

Surprise medical bills may arise when a patient unintentionally visits a doctor or healthcare facility that does not contract with the patient's health insurer. Surprise billing is common, with 4 in 10 insured adults reporting they received a surprise medical bill in the last year.

The groups—which include powerful lobbyists like the Blue Cross and Blue Shield Association, America's Health Insurance Plans, the National Business Group on Health, and Consumers Union—called on Congress to prohibit providers from billing patients for costs not covered by the health plan when the out-of-network visit isn't the patient's fault.But they also said Congress should ensure any policy enacted doesn't increase premiums or discourage providers from joining a health plan's network.

The groups ultimately pinned the blame for surprise billing on providers.  "When doctors, hospitals or care specialists choose not to participate in networks, or if they do not meet the standards for inclusion in a network, they charge whatever rates they like," the groups wrote. "The consequence is millions of consumers receiving surprise, unexpected medical bills that can often break the bank."

The CEOs of the American Hospital Association and the Federation of American Hospitals quickly hit back in a joint statement, saying health plans' inadequate provider networks are one of the "root causes" of surprise medical bills.

While some states, including California, Connecticut, Florida, Illinois, Maryland and New York, have passed comprehensive consumer protection laws to protect patients from surprise out-of-network medical bills, the federal government has yet to tackle the issue.