No More Surprises: E&C Examines how to Protect Patients from Surprise Medical Bills
WASHINGTON, DC – Energy and Commerce Committee Republican Leader Greg Walden (R-OR) is working to protect patients from surprise medical bills. Walden has drafted bipartisan legislation with Chairman Frank Pallone to shield families across the country from these harmful, unexpected medical bills and the Energy and Commerce Committee will examine the proposal during the hearing with expert witnesses. Walden delivered the following opening remarks today at a Subcommittee on Health hearing on “No More Surprises: Protecting Patients from Surprise Medical Bill.”
As Prepared for Delivery
Thank you, Madam Chair, and Dr. Burgess for holding this hearing. I’d also like to thank the Chairman of the full committee, Mr. Pallone, for working in good faith and in a bipartisan manner to release a discussion draft to address surprise billing.
This hearing is really about patients. We’ve all heard the stories from our constituents. Patients who follow the rules, pay their premiums, and then through no fault of their own, following an emergency situation or surgery receive a six-digit bill in the mail weeks later, which they have no way of paying. It is not fair. It should not happen.
We must protect patients from these bills, and we want to get it right. Since we released this draft last month, Chairman Pallone and I have received over 60 comment letters on this draft from stakeholders across the health care industry. That feedback is critical as we work to take the patient out of these surprise billing scenarios without raising overall health care costs.
I’d like to thank all our witnesses for being here today, many of whom have provided that helpful feedback on this bill. I’d particularly like to thank Ms. Wilkes – unfortunately you’ve become an expert on this topic the hard way, by living through it with your children. As a parent I share your frustration and your desire to fix surprise billing once and for all.
Unfortunately, as you know, your experience is not unique – I recently spoke with a doctor whose daughter’s case has become pretty well-known: she had been in the hospital, and on the way out her provider suggested that she take a simple drug test. Little did she know, that test was sent to an out-of-network lab and she soon received a $17,850 bill in the mail. She had no reason to know, or even think to ask, if the lab was in- or out-of-network. She was just following her doctor’s advice. Situations like hers and yours, Ms. Wilkes, are why we’re here today. We have to stop this. And it is why Chairman Pallone and I are moving forward with legislation to protect patients.
I’m also pleased that the President has taken on this issue. He was very serious about fixing surprise billing at a bipartisan event at the White House a few weeks ago. I am encouraged that our draft legislation lines up well with the principles the White House has set forth for a solution that could get the President’s signature and become law.
The draft before us today, the No Surprises Act, would take a number of steps to address surprise medical bills. First, and most importantly, this bill prohibits balance billing of patients and limits a patient’s bill to their in-network cost-sharing amount in emergency situations. This is commonsense when a patient has little to no control over who gives them life-saving care and can hardly be expected to make sure everyone is in-network. For scheduled care like elective surgeries, patients must receive both verbal and written notice of any out-of-network providers who will be involved in their care – if they don’t consent to that notice, then they can’t be balance billed.
Under our draft bill, providers who would currently balance bill the patient will instead be paid by the patient’s insurer at the median in-network rate for the service they provided in that geographic area. My home state of Oregon passed legislation on surprise billing last year with a similar approach, and other states have passed their own models that create an arbitration process for providers and insurers to come to an agreement on a reasonable payment – and there are combinations of the two. Under our draft, these state laws would remain in place.
There are a number of options on how to deal with the payment to providers, and I look forward to hearing from our panel on their experience with these different models.
In closing, I would like to once again stress how important this issue is to our constituents. I understand there are competing interests here today and I expect plenty of back and forth on the policies in the draft. Protecting patients, however, must be put at the forefront of this discussion and I will continue to work with my colleagues on both sides of the aisle to do just that.
Thank you, Madam Chair, and I yield back.