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U.S. Rep. Michelle Lujan Grisham Introduces Legislation To Ban Surprise Billing

on October 4, 2017 - 5:08pm
U.S. Rep.  Michelle Lujan Grisham
WASHINGTON, D.C. U.S. Rep.  Michelle Lujan Grisham introduced health care legislation that will prohibit surprise billing. The Fair Billing Act is designed to protect patients from being charged expensive out-of-network rates for services they get at in-network hospitals.
“Medical billing is extremely complicated, even in the best of circumstances,” Rep. Lujan Grisham said. “Consumers who have done their homework, choosing an in-network provider covered by their insurance and doing their best to plan for the expense of a particular procedure, treatment, or service should not be held responsible for these unexpected costs.
“The only thing a patient should be worrying about when they go to an in-network hospital is the care they are going to receive, not whether a surprise bill will be waiting for them when they get home.”
More than one-third of Americans have received a surprise medical bill, usually when they receive care from an out-of-network provider at an in-network facility without their knowledge, or receive emergency care.
The Fair Billing Act would do the following:
  • Patients will not be asked to pay more than the cost-sharing amount they would have been required to pay for care provided by an in-network provider.
  • Providers will be permitted to charge higher rates only if they obtain written consent from the patient at least 72 hours in advance.
Rep. Lujan Grisham’s legislation is modeled after several state laws that have successfully ended surprise billing.
“The Fair Billing Act will increase transparency and cut consumers’ health care costs by prohibiting surprise billing,” said Rep. Lujan Grisham.