Biden administration moves forward on banning surprise medical bills

[Yo_Mama_Been_Loggin]

The government took the first steps to end surprise medical billing on Thursday, getting the ball rolling on a law that was passed under former President Donald Trump's administration and takes effect this January.

The law bans health care providers from issuing surprising bills that are shockingly high because patients unknowingly got out-of-network procedures even though they were at doctors' offices or hospitals that take their insurance. One example of the practice is a patient getting surgery at a hospital that's in-network but then being billed thousands of dollars because the anesthesiologist who put them under was out-of-network.

Starting in January, instead of being charged a high out-of-network rate without advanced notice, the new rule issued by the Department of Health and Human Services on Thursday mandates that hospitals and doctors' offices notify patients when they're receiving out-of-network care and charge people an in-network price for it. It also creates a complaint system to report surprise billing.

"It bans high out-of-network charges that come without advanced notice," Health and Human Services Secretary Xavier Becerra said at a press conference on Thursday.

https://www.msn.com/en-us/news/us/biden-administration-moves-forward-on-banning-surprise-medical-bills/ar-AALHSkl

[zuul]

1. I've been through this nightmare 3 times.

For each surgery, I asked my insurance agent the total of my out-of-pocket expenses before the procedure was done. The answer every time was "Don't know. You'll have to talk to the hospital."

Then I contacted the hospital. Same answer every time: "Don't know. You'll have to talk your insurance company."

They both know that if they were honest about the out-of-pocket costs, some people would forgo the procedure. I need back surgery right now but I'm hesitant because of the surprise costs.

Thank you President Biden!

[Hortensis]

2. Per WaPo, the rules are to begin in January, Zuul. We're still waiting

for a surprise shoe to fall from my husband's recent shoulder replacement, but we have Medicare and purchase a supplemental policy and were told ahead of time that they typically covered all bills. We'll see, and best wishes to you.

Thursday’s rules spell out that, if a health plan provides for any emergency services, those services must be covered without requiring permission from an insurer ahead of time. And no matter whether the emergency room or its doctors are part of the insurer’s network, patients may not be charged more for emergency care or air ambulances than if those services were given by providers in the insurer’s network. ...

Another aspect of the rules bans higher charges in instances in which an anesthesiologist, assistant surgeon or others providing such ancillary care are outside of a network even though the patient’s main surgeon is part of a health plan’s network of allowed medical personnel and facilities.

As the insurance industry has used fixed networks of doctors and hospitals as a way to rein in medical spending, out-of-network bills have emerged in recent years as a big source of patients’ ire. Unlike many ideas for controlling medical expenditures in the United States that are ensnared in partisan wrangling, blocking such big, unexpected bills has united the sympathies of Democrats and Republicans. Members of Congress sparred for nearly two years over different approaches to protecting patients from surprise bills, but the parties coalesced around the “No Surprises Act” as part of a coronavirus pandemic relief package lawmakers passed days before Christmas last year. ...

About two-thirds of U.S. adults said they were very or somewhat worried about being able to afford large bills from a health-care provider outside their insurance network, according to polling earlier this year by the Kaiser Family Foundation, a health-care policy group. Worry about such bills exceeds concerns about affording prescription drugs or other parts of their health insurance, such as deductibles or monthly premiums, Kaiser’s survey shows.

Other Kaiser data, published last year in the Journal of the American Medical Association, shows that 1 in 5 insured adults had received an unexpectedly high medical bill from an out-of-network provider of care in the previous two years.

https://www.washingtonpost.com/health/surprise-medical-bill-regulations/2021/07/01/7c0deb64-da8b-11eb-8fb8-aea56b785b00_story.html

[zuul]

3. Thank you. Hope your hubby is doing well!