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Wednesday, September 26, 2018

How The Senate is Helping To Eliminate Surprise Medical Bills

Medical treatment and its costly expense have left many Americans frustrated and in medical debt. Acknowledging the ever-growing need for medical bill assistance, a bipartisan group of the Senate recently proposed a plan to protect patients from the unexpected surprise of paying medical bills and expensive charges from doctors or hospitals that are not in their current insurance network.

How The Senate is Helping To Eliminate Surprise Medical Bills

HealthAffairs reported this week that multiple states (Arizona, Missouri, New Hampshire, New Jersey, and Oregon) have tried to ease the burden of surprise medical debt, but were curbed in their efforts because current state laws don’t apply to privately-insured Americans enrolled in “self-insured” health plans that are popular among large employers. Since the states can’t affect change, it’s up to the federal government.

The Senate is helping to eliminate surprise medical bills by introducing a bipartisan proposal, BenefitsPro reports.  Designed to prevent unnecessary medical bankruptcies, the draft legislation has decided to target the following key consumer concerns:

1) Emergency treatment conducted by a doctor who is not part of the patient’s insurance network and is conducted at a medical center (hospital) outside of the network. Patients in this predicament would be required to pay for these costs out-of-pocket due to the limitations of their insurance plan. Both the hospital and doctor could seek additional payment(s) from the insurer of the patient through the new proposal.

2) Those treated by a doctor outside of their network or another provider at a hospital within the patient’s insurance network. The new bill would allow patients to pay only what is required by their plan. However, doctors could still seek further payments from the plan based on the formulas that the patient’s state has set up.

3) Lastly, those that receive a mandated notification as an emergency patient, once stabilized, could incur excess charges if they are treated at an out-of-network hospital. Patients in this scenario would be required to sign a statement that would acknowledge they had been informed their insurance would most likely not cover all expenses and they could seek further treatment elsewhere.

Giving Patients A Helping Hand

Sen. Bill Cassidy (R-La.), announced that “Our proposal protects patients in those emergency situations where current law does not  so that they don’t receive a surprise bill that is basically uncapped by anything but a sense of shame.” Aside from emergency room and out-of-network hospital visits, patients can face very expensive bills for using a ground or air ambulance to be transported to a medical facility.

While the Senate gets a toehold on mitigating medical debt, you can get ahead on your Affordable Care Act reporting for 2018. ACAwise provides full-service ACA reporting and is certified to help you ease the burden of distributing your 1094 and 1095 forms! Schedule an appointment with one of our account managers today.

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