Surprise medical bills have been the focus of many discussions in Washington over recent months. They refer to services billed when a patient uses out-of-network providers in the following scenarios:
Under the current legislation, providers can bill patients for the balance. These surprise medical bills cover the difference between the hospital's fees and the insurer's payment.
They can be extremely costly and often come as a huge surprise to the patient. Sometimes the patient is not even aware they're using an out-of-network provider — or they don't have any control over the out-of-network services taking place. This means they were unable to give their consent before the treatment took place. As such, many deem the bills to be unfair on many levels.
Earlier this year, forty businesses wrote a letter to Washington, campaigning for change. The letter urges lawmakers to make the legal changes necessary to protect patients from surprise medical bills.
The letter focused on four key areas:
Network participation is an important part of our healthcare system. The organizations behind the letter make this clear. It's not about discouraging network participation but making the changes necessary to protect patients from crippling medical bills beyond their control.
Because the fact is, many patients don't have any choice in the provider when they seek medical treatment.
The organizations make a number of suggestions in their letter.
Controversial incentives currently exist in relation to emergency treatment. This means, in some instances, in-network hospitals can profit from outsourced emergency treatment. Lawmakers should seek to eliminate these incentives.