House Ways and Means Committee Chairman Richard Neal, D-Mass., and Ranking Member Kevin Brady, R-Texas, this morning released legislative text of the Consumer Protections Against Surprise Medical Bills Act of 2020, the committee’s proposal to address surprise medical bills. The legislation prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and does not allow patients to be charged more than the in-network cost-sharing amount. The proposal does not rely on a benchmark payment rate to determine out-of-network reimbursement, but instead includes a period for health plans and providers to negotiate reimbursement, to be followed by a mediated dispute resolution process should it be necessary. The proposal also includes several other consumer protection and transparency provisions. The committee is expected to mark up the legislation on Wednesday, Feb. 12.
In addition, House Committee on Education and Labor Chairman Robert “Bobby” Scott, D-Va. and Ranking Member Virginia Foxx, R-N.C., this morning unveiled the Ban Surprise Billing Act. The legislation is similar to the bills passed last year by the House Energy and Commerce Committee and Senate Health, Education, Labor and Pensions Committee in that it relies on a median in-network rate to resolve out-of-network payments. For amounts paid above $750 (or $25,000 for air ambulance services), the legislation allows for an independent dispute resolution process to determine the final payment. A summary of the legislation is here and legislative text was released late this afternoon. The committee is scheduled to mark up the legislation on Tuesday, Feb. 11.