Considerations for Policymakers
There is bipartisan consensus that patients should not face surprise medical bills when they receive services from an out-of-network health care provider due to an emergency or other circumstance outside of their control. Fortunately, federal and state policymakers can protect patients by eliminating or limiting these unexpected medical bills.
NOTE: Congress recently enacted the federal No Surprises Act, a new federal law that protects patients from surprise medical bills in all states. These comprehensive new protections will go into effect beginning in 2022 and will protect patients from surprise medical bills for emergency services (including air ambulances) and non-emergency services provided at an in-network facility. Patients’ out-of-pocket costs will be limited to the costs they would have paid if they had received services from an in-network doctor, hospital, or other health care provider. The considerations here may continue to be relevant (especially for state policymakers interested in pursuing separate protections) but we recommend that readers learn more about the No Surprises Act here.
To help inform policymakers as they debate a range of patient protection options, we have identified key considerations for addressing surprise medical bills. Read more about these policy options here:
- Taking the Patient Out of the Middle
- Scope of Protections
- Resolving Payment Disputes Between Insurers and Providers
- Other Options
We Are Here to Help
Our goal is to help policymakers adopt comprehensive surprise billing protections for patients. Policymakers and staff can contact our team about a specific question or with a broader request for technical assistance. Our experts are available to review materials and consult on policy solutions.