Biden administration seeks to end surprise medical bills by the beginning of next year

Medical bills can be a stressful occurrence in someone’s life. Money can be tight for a lot of people and if the bills are unexpected, then the stress would only magnify. We see this happen all the time in cases we handle like semi-truck accident claim. It looks like the government is going to try to do something about it. The Biden administration recently put the finishing touches on consumer protections against so-called “surprise” medical bills. Government officials say that this ban is on track to take effect Jan. 1. If this ban is successful, then patients across the country will no longer have to worry about medical bills that occur during incidences where the closest hospital emergency room happened to have been outside their insurance plan’s provider network. Patients will also be protected from unexpected charges if an out-of-network medical personnel takes part in a surgery or procedure conducted at an in-network hospital. The new rules are part of a behind-the-scenes dispute resolution process that hospitals, doctors and insurers will use to haggle over fees, without dragging patients into it.

The plan also includes a new method for uninsured people and patients who pay their own way to get an estimate of charges for medical procedures, as well as a process for them to resolve billing disputes. “We’re hoping to give folks a sigh of relief, who have been blindsided by billing,” said Health and Human Services Secretary Xavier Becerra. These surprise medical bills have been a frequent occurrence for people with health insurance, and it is estimated that about 1 in 5 emergency visits and 1 in 6 inpatient admissions triggered a surprise bill.

The law’s new protections are aimed at:

— Protecting patients from surprise bills arising from emergency medical care. Protections apply if the patient is seen at an out-of-network facility, or if they are treated by an out-of-network clinician at an in-network hospital. In either case, the patient can only be billed based on their plan’s in-network rate.

— Protecting patients admitted to an in-network hospital for a planned procedure when an out-of-network clinician gets involved and submits a bill.

— Requiring out-of-network service providers to give patients 72-hour notice of their estimated charges. Patients would have to agree to receive out-of-network care for the hospital or doctor to then bill them.

— Barring air ambulance services from sending patients surprise bills for more than the in-network cost sharing amount.