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Biden Administration Pushes Forward With Law on Surprise Medical Bills

Proposed provisions would more clearly outline charges to be expected during medical emergencies, offer protections to consumers

FRIDAY, July 2, 2021 (HealthDay News) — In a rare show of bipartisanship on health care, the Biden Administration is advancing Trump-era consumer protections aimed at curbing sometimes devastating surprise medical bills.

According to the Associated Press, about one in every five emergency care visits and one in every six inpatient hospital admissions will result in a surprise bill. Many of them arise from care involving a high-demand — but out-of-network — physician or anesthesiologist who may stay out of insurance networks to maximize their incomes.

However, the Biden Administration signaled on Thursday that it was pushing forward with legislation that began life in the Trump era. The proposed protections, issued by four federal agencies, would more clearly outline charges to be expected during medical emergencies and offer protections to consumers for charges from out-of-network doctors working at an in-network facility.

Central provisions of the legislation include the following: (1) holding patients harmless for extra charges necessitated by emergency medical care. That holds true whether or not a patient is seen at an in-network facility, or if an out-of-network doctor treats them at an in-network facility; (2) mandating that out-of-network service providers give patients 72 hours notice of what charges might be expected. Patients would then have to give their consent to the out-of-network care before being billed; and (3) barring air ambulance services from sending patients surprise bills for more than the in-network cost sharing amount.

The new protections are, under law, required to go into effect by Jan. 1. In the meantime, many groups, including those advocating for patients, are poring over the new 400-page document. The Biden Administration is allowing 60 days of public comment on the new rules.

Associated Press Article

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