Congress takes up surprise medical bills: 7 things to know

The House recently held its first hearing on surprise medical bills as federal lawmakers work on a legislative solution to address the issue, The Wall Street Journal reports.

Seven things to know:

1. Democrats and Republicans agree on finding a solution to protect patients from unexpected costs after receiving care from an out-of-network provider, but they're divided on how to determine how much an insurer will pay healthcare providers for out-of-network patients, according to the WSJ.

2. Insurers want the federal government to limit what healthcare providers can charge for out-of-network bills, the WSJ reports. But hospitals and some medical specialty groups are against the government regulating prices between private businesses, saying this could eventually result in wide-ranging federal rate-setting in the healthcare industry, according to the WSJ.

3. Various legislative solutions were the focus of a House Education and Labor Committee hearing April 2.  

4. One idea is using arbitration between physicians and insurers to settle price disputes. Insurers are opposed to this.

5. Representatives of employees, large and small American businesses, health insurance providers and brokers sentletter to congressional leaders March 18, urging them to "avoid the use of complex, costly and opaque arbitration processes that can keep consumers in the middle and lead to higher premiums."

6. Another legislative idea calls for patients to receive one "bundled" in-network bill after they receive care from an out-of-network provider at an in-network emergency room. Payments would then be negotiated between hospitals and the out-of-network providers.

7. The Federation of American Hospitals, American Hospital Association and American Medical Association came out against bundled billing earlier this week.

Read the full WSJ report here.


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