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Surprise Billing Legislation Stalls in Congress … For Now
Posted on: 12/18/2019

In recent weeks it has been reported that bipartisan legislation to protect patients from surprise medical bills was emerging from the U.S. House Ways and Means Committee. "Surprise billing" is the favored term to describe when an insured patient receives care at an in-network hospital or facility and then is shocked to receive a bill for services provided there by an out-of-network healthcare professional.

The House Energy and Commerce Committee and the Senate Health, Education, Labor and Pension Committee were advancing similar bipartisan legislation. Given the bipartisan support, some lawmakers were seeking to have the issue addressed through an omnibus spending bill that is expected to advance.

As we went to press, ISMS has learned the surprise billing provisions are not expected to be included in the spending package, in part due to concerns raised by organized medicine. ISMS, the AMA and other physicians’ organizations have been vocal about our concern that patients must be protected; the proposals under consideration were overly favorable to insurers, especially in relation to how disputes are resolved.

Despite the delay, this debate is far from dead and is expected to return next year. 

ISMS will keep you updated about this legislation via Physician Advocate.

If you have questions, please contact David Porter, ISMS’ Vice President of Health Policy Research and Advocacy, at 312-580-2468 or by email.

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