AHA, FAH: Policies to address surprise bills must protect patients

The AHA and Federation of American Hospitals “strongly believe that any public policy solution to resolve surprise bills must protect patients by prohibiting balance billing and by limiting patients’ cost-sharing to an in-network amount,” the organizations today told members of Congress. “We appreciate that this is a high-priority issue for Congress, as it is for us, and we intend to provide more specific feedback to policymakers early in the new Congress,” the organizations said in a letter to Congressional leadership, members of the Bipartisan Senate Working Group on Health Care Price Transparency and other interested members of Congress. AHA and FAH said they are evaluating, for example, how to protect the broadest range of patients, including those in self-insured plans; how cost-sharing should be determined for out-of-network care so that patients have certainty about their financial obligations; the role of network adequacy requirements and enforcement in ensuring patients have sufficient access to in-network care; and whether policy interventions are needed to determine fair provider payment.