Reps. Taylor, Ruiz, Roe, Morelle Introduce Legislation to End Surprise Medical Billing

Press Release

Today, United States Congressman Van Taylor (TX-03) joined with Republicans and Democrats in the House to introduce bipartisan legislation to end the practice of surprise medical billing.

The Protecting People from Surprise Medical Bills Act aims to end surprise medical bills, ensuring patients are prevented from paying more than their in-network rates.

With widespread bipartisan support, the legislation has thirty two original cosponsors from both sides of the aisle in addition to support from Members on the committees of jurisdiction including the Energy and Commerce, Ways and Means, and Education and Labor Committees.
"Americans are already struggling to afford the continually increasing cost of health care -- they shouldn't be blindsided by unexpected and hyperinflated medical bills when they unexpectedly need to see out-of-network providers," said Congressman Van Taylor. He continued, "Reducing out-of-pocket health care cost isn't a partisan issue and I am proud to come together with my colleagues to introduce this commonsense legislation to end surprise billing and give more certainty to all Americans."

"The Protecting People from Surprise Medical Bills Act is gaining momentum because it includes the strongest patient protections of any surprise billing legislation proposed in the House or Senate," said Dr. Ruiz. "Our bill creates the most fair and transparent system to end surprise bills -- without picking winners or losers. This bill is the best solution to protect middle-class families from the severe anxiety, depression, and financial ruin that can result from receiving an unexpected and very expensive bill from an out-of-network provider."

The predatory practice of surprise billing is yet another example of why our healthcare system doesn't work for everyday Americans," said Rep. Morelle. "Patients in need deserve better than to be blindsided with a massive, unexpected medical bill in the middle of an emergency. I was proud to help pass measures to end surprise billing during my time in the State Assembly, and now I'm pleased to come together with my colleagues on both sides of the aisle to introduce similar legislation and bring much-needed peace of mind to families across the country."

"For far too long, families and patients have endured financial stress and other hardships because of costly surprise medical bills," said Rep. Roe. "Too many Americans are only a car crash away from financial ruin, and the time is now to ensure families have peace of mind. For this reason, I am proud to work with my colleague Dr. Ruiz on a bipartisan solution that will help end this practice and ensure providers and insurers can work out any payment disagreements through arbitration. Our legislation is based on a proven, tested model from New York state, and I am confident that if enacted, this will prove helpful for patients, providers, insurers, employers and taxpayers."
Background

For too long, Americans have been victim to the practice of surprise billing that leaves patients with massive, unexpected charges after they receive emergency out-of-network medical care. Too often, these bills are for hundreds of thousands of dollars and can come weeks or months after a procedure, blindsiding patients and their families.

The Protecting People from Surprise Medical Bills Act is modeled after the first-in-the-nation consumer protection act against surprise bills enacted in New York in 2015 and the recently-passed surprise billing prohibition in Texas. It would ensure patients are held harmless and prevent out-of-network providers from billing patients directly for unanticipated, out-of-network care. The policies set forth in the proposal would also establish a system of arbitration and dictate that any disputes be resolved directly between the provider and the insurer, without involving the patient, quickly and efficiently.

Under the Protecting People from Surprise Medical Bills Act, the practice of balance billing would be banned. Patients would be protected from involvement in resolving payment disputes. The legislation sets forward the most robust patient protections possible, ensuring families are not bankrupted by surprise medical bills.

Specifically, the Protecting People from Surprise Medical Bills Act:
Bans the practice of billing patients for unanticipated out-of-network care
Implements a "baseball-style' arbitration model that identifies a reasonable payment rate when insurers and providers cannot agree on the cost of care
Improves transparency by requiring health plans to clearly identify in-network providers and patients' deductibles
A detailed summary of the legislation can be found here and the complete bill text can be found here.

Original cosponsors of the legislation include Representatives Ami Bera (CA-07), Larry Bucshon (IN-08), Tim Burchett (TN-02), Mark DeSaulnier (CA-11), Scott DesJarlais (TN-04), Neal Dunn (FL-02), Raul Grijalva (AZ-03), Brian Higgins (NY-26), Richard Hudson (NC-08), John Joyce (PA-13), Nita Lowey (NY-17), Roger Marshall (KS-01), Joseph Morelle (NY-25), Donald Norcross (NJ-01), Denver Riggleman (VA-05), David Roe (TN-01), Raul Ruiz (CA-36), Donna Shalala (FL-27), Lloyd Smucker (PA-11), Elise Stefanik (NY-21), Steve Stivers (OH-15), Glenn Thompson (PA-15), Steven Watkins (KS-02), and Ron Wright (TX-06).

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