June 27, 2019

Congress Considers Legislation to Address Surprise Billing

The U.S. Senate Committee on Health, Education, Labor and Pensions is considering legislation to ban surprise billing that would set a benchmark payment rate for out-of-network services at the median in-network rate for a geographic area. The Lower Health Care Costs Act of 2019, introduced by committee chairman Lamar Alexander (R-TN) and ranking member Patty Murray (D-WA), also seeks to address drug prices and transparency in health care.

“This legislation will reduce what Americans pay out of their pockets for health care in three major ways,” stated Sen. Alexander. “First, it ends surprise billing; second, it creates more transparency — you can’t lower your health care costs until you know what your health care actually costs. And third, it increases prescription drug competition to help bring more lower cost generic and biosimilar drugs to patients.”

The Senate bill’s provisions on surprise billing are similar to House Energy and Commerce legislation, the No Surprises Act, which was the subject of a June 12 hearing “to protect patients from the unreasonable and unacceptable practice of surprise billing.”