Category: surprise bills

Suit by Doctors, Hospitals Seeks Change in How Arbitrators Settle Surprise Billing Cases

The American Medical Association and American Hospital Association are not arguing to halt the law that protects patients from unexpected bills from providers they didn’t know were outside their insurance network. Instead, they want to change the rules for the mediators who will settle the dispute between insurers and providers.

Becerra Says Surprise Billing Rules Force Doctors Who Overcharge to Accept Fair Prices

The Health and Human Services secretary says the administration has heard complaints from doctors and hospitals about the rules it unveiled for implementing the law to end surprise medical bills. But he says providers who have exploited a complicated system to charge exorbitant rates will have to bear their share of the cost — or close.

Congressional Doctors Lead Bipartisan Revolt Over Policy on Surprise Medical Bills

Congress last year shielded consumers from unexpected out-of-network charges, but hospitals and doctors have decried the arbitration plan put forward by the Biden administration for negotiating these bills as favoring insurers. More than 150 members of the House agree.

KHN’s ‘What the Health?’: Compromise Is Coming — Maybe

Democratic negotiators on Capitol Hill appear to be nearing a compromise on President Joe Biden’s social spending agenda, spurred partly by Democratic losses on Election Day in Virginia. Meanwhile, the Supreme Court hints it might allow abortion providers to sue Texas over its restrictive new ban. But the relief, if it comes, could be short-lived if the court uses a second case, challenging a law in Mississippi, to weaken or overturn Roe v. Wade. Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times and Mary Ellen McIntire of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Rae Ellen Bichell, who reported and wrote the latest KHN-NPR “Bill of the Month” feature about an emergency bill for a nonemergency birth.

KHN’s ‘What the Health?’: The Health Agenda Still on Hold

Negotiations continue on Capitol Hill over President Joe Biden’s health agenda — along with a long list of other items. With Republicans on the sidelines, liberal Democrats delayed a House vote on a Senate-passed infrastructure bill to extract moderates’ support for a social-spending bill that includes expansions of benefits for Medicare, Medicaid and the Affordable Care Act. Meanwhile, the Biden administration’s new rules to prevent “surprise” medical bills pleases some health stakeholders and angers others. Alice Miranda Ollstein of Politico, Tami Luhby of CNN and Kimberly Leonard of Insider join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Anna Flagg of the Marshall Project about how a century-old report on medical education contributed to racial inequities that persist today.

At Urgent Care, He Got 5 Stitches and a Big Surprise: A Plastic Surgeon’s Bill for $1,040

The Biden administration is weighing how to treat urgent care clinics as part of broad regulations banning surprise, out-of-network medical bills. At the heart of the matter: What counts as an emergency?

KHN’s ‘What the Health?’: 2020 in Review — It Wasn’t All COVID

The coronavirus pandemic colored just about everything in 2020. But there was other health policy news that you either never heard or might have forgotten about: the Affordable Care Act going before the Supreme Court with its survival on the line; ditto for Medicaid work requirements. And a surprise ending to the “surprise bill” saga. Joanne Kenen of Politico, Anna Edney of Bloomberg News and Sarah Karlin-Smith of Pink Sheet join KHN’s Julie Rovner to discuss these issues and more.

Surprise! Congress Takes Steps to Curb Unexpected Medical Bills

A long-debated measure to stop doctors, hospitals and other health care providers from billing patients for charges not covered by their insurance will gain congressional approval as part of the sweeping government spending package.

KHN’s ‘What the Health?’: All I Want for Christmas Is a COVID Relief Bill

Congress seems on the verge of finishing a long-delayed COVID-19 relief bill, which will reportedly include neither of the things each party wanted most — for Republicans, liability protections; for Democrats, funding for states and localities. That bill is likely to be tied to a package to fund the federal government for the rest of the fiscal year and, possibly, include a fix for “surprise” medical bills that patients receive when they inadvertently receive care outside their insurance network. Alice Miranda Ollstein of Politico, Rebecca Adams of CQ Roll Call and Mary Agnes Carey of KHN join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner talks to Elizabeth Mitchell, president and CEO of the Pacific Business Group on Health, about the future of employer-provided health insurance.

With No Legal Guardrails for Patients, Ambulances Drive Surprise Medical Billing

Studies show that at least half of ground ambulance rides across the nation leave patients with “surprise” medical bills. And a $300-a-mile ride is not unusual. Yet federal legislation to stem what’s known as balance billing has largely ignored ambulance costs.