ACEP released its proposal Jan. 28 as Congress prepares to address surprise billing issues. President Donald Trump also recently vowed to end surprise medical bills during a roundtable at the White House.
The framework is listed below. For more specific information on the proposals, click here.
1. Prohibit balance billing by not allowing providers to ask for payment for out-of-network emergency care.
2. Ensure patients only have one point of contact for emergency medical billing and payment by having insurers directly pay any coinsurance, copay and deductible to the provider. If necessary, insurers can then collect amounts from the patient.
3. Ensure the patient responsibility portion for out-of-network emergency care is no higher than it would be in-network.
4. Require insurers to more clearly convey beneficiary plan details, such as printing deductibles on each insurance card.
5. Require insurers to clearly explain patient rights related to emergency care.
6. Take the patient out of insurer-provider billing disputes by creating an arbitration process to settle network issues.
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