House Subcommittee Advances Legislation on Surprise Medical Bills, DSH Cut Delay

A House panel unanimously advanced a bipartisan measure to tackle surprise medical bills that would use a benchmark to solve billing disputes—an approach favored by payers—despite calls from providers to use arbitration.

The bill would ban balance billing and prohibit any surprise medical bills from a hospital-based provider that the patient can’t reasonably choose, such as in an emergency room. “For all other scheduled care at an in-network facility, the legislation would require that patients receive a notice and provide their consent to out-of-network care,” according to a committee memo on the bill.

If a patient doesn’t get this notice, then the provider can’t balance bill the patient.

The legislation also creates a payment benchmark that would be used to resolve disputes over the amount for an out-of-network payment.

Source: https://www.fiercehealthcare.com/payer/house-subcommittee-advances-legislation-surprise-medical-bills-dsh-cut-delay