New coalition of health care leaders calls for action against “surprise” medical billing

By Regence
December 19, 2018

Consider this scenario: An $8,000 bill for an emergency room visit arrives in the mail, unexpected considering the hospital you visited was in-network. What do you do?

This year, it’s estimated that one in every 10 adults has received a so-called “surprise” bill from a doctor, lab or other health care provider, often the result of a patient visiting a hospital covered by their insurance network but receiving treatment by a contract physician who is not part of the network.

In response, health care leaders are taking action and have formed a new coalition that is advocating on behalf of consumers for policies to protect patients from surprise medical bills. The coalition is comprised of select insurance, business and consumer groups – including the Blue Cross Blue Shield Association – and has set forth guiding principles to push for stronger consumer protections and the elimination of surprise billing.

The coalition’s guiding principles include:

  • Federal legislation to end surprise medical bills.
  • “Right to Know” policies, allowing patients to know the true costs of their care and their options.
  • A federal standard for payment of out-of-network doctors.

In a statement announcing the coalition, America’s Health Insurance Plans (AHIP) reports: “When doctors, hospitals, or care specialists choose not to participate in networks – or if they do not meet the standards for inclusion in a network – they charge whatever rates they like. The consequence is millions of consumers receiving surprise, unexpected medical bills that can often break the bank.”

Read AHIP’s full statement to learn more about this coalition, its members and the full set of guiding principles.