Congress Bans Most Surprise Medical Bills

By Consumers For Quality Care, on January 6, 2021

As part of a massive year-end spending package, Congress passed a bill that included language to ban surprise medical billing, according to the New York Times.

Most surprise medical billing occurs when an out-of-network provider is involved in the patient’s care and leaves the patient with the bill. This is common practice in emergency rooms, where patients may unknowingly be treated by out-of-network doctors, leaving them with an average surprise charge just above $600.

“This was a real victory for American people against moneyed interests,” said Frederick Isasi, executive director of Families USA. “This really was about Congress recognizing in a bipartisan way the obscenity of families who were paying insurance still having financial bombs going off.”

The bill requires health care providers to work with insurers to settle on a fair price, rather than simply charge the patient. It also requires insurers and medical providers who cannot agree on a payment rate to use an outside arbiter to determine a fair cost based on what others paid for similar services.