Surprise medical-bill protection included in relief package

It protects emergency-room patients who get treatment from doctors not in their care network.

Dec 21, 2020

Legislation to protect Americans from getting “surprise” medical bills has been included in the year-end deal that is expected to pass Congress today.

The legislation is key amid the coronavirus pandemic. It will protect patients who go to emergency rooms and get treatment from a doctor who may not be in their care network.

Speaker of the House Nancy Pelosi and Senate Minority Leader Chuck Schumer speak after a press conference on Capitol Hill Sunday in Washington, D.C. Republicans and Democrats in the Senate finally came to an agreement on the coronavirus relief bill. (Photo by Tasos Katopodis/Getty Images)

The bipartisan legislation had identified those expenses as a problem for Americans for months. However, lobbyists who represent doctors, large health care groups, hospitals and insurers successfully pushed to temper the costs that insurance companies would have to pay.

The No Surprises Act will require insurers and providers to resolve payment disputes on their own. Critics of the measure note that it doesn’t establish a benchmark payment standard for insurers to pay out-of-network providers.

The final measure leans toward the powerful leverage of the medical-care industry. The legislation will use arbitration to determine how much insurers will pay doctors who are not in their networks. However, it will not include consideration of the low payment rates that are paid by Medicare and Medicaid.

Speaker of the House Nancy Pelosi noted she was “very proud that surprise billing” is a part of the relief package.

According to The Hill, Nancy Brown, chief executive officer of the American Heart Association, praised the effort. “Patients nationwide have been waiting for years for legal protection from financially devastating surprise bills,” she said, “and now relief is in sight.”

The bipartisan legislation brought together lawmakers from across ideologies and the national map.

“For far too long, our constituents have done everything right at the doctor’s office or hospital yet still found themselves stuck with surprise medical bills, sometimes to the tune of tens of thousands of dollars,” senators Bill Cassidy, a Republican from Louisiana, and Maggie Hassan, a Democrat from New Hampshire, said in a joint statement.

Before the pandemic, 78 percent of Americans supported legislation to protect them from surprise medical bills. The coronavirus pandemic has made medical costs an even greater concern, as millions have had to seek medical treatment for the novel COVID-19, which has killed over 311,000 people in this country.

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