National healthcare groups outline surprise-billing principles

Six national healthcare groups penned a letter to Congress Feb. 20 outlining principles for lawmakers to consider amid their efforts to eliminate surprise billing.

"The last thing a patient should worry about in a health crisis is an unanticipated medical bill," said Rick Pollack, president and CEO of the American Hospital Association. "We must protect patients from surprise bills that could unintentionally impact their out-of-pocket costs and undermine the trust and confidence patients have in their caregivers."

America's Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States, Children's Hospital Association and Federation of American Hospitals also signed off on the letter.

The groups said lawmakers should:

  • Define "surprise bills," which may occur when patients receive care from a provider who is not in their insurance network, or when there are unexpected gaps in health plan coverage
  • Provide certainty regarding patient cost-sharing obligations and not bill patients beyond those obligations
  • Ensure patients have access to and coverage of emergency care
  • Ensure health plans and providers retain the ability to privately negotiate appropriate payment rates
  • Remove patients from the middle of negotiations between insurers and providers
  • Include an educational component in legislation so patients understand their healthcare coverage
  • Ensure patients are able to access "a comprehensive network of providers"
  • Support state laws that protect patients from surprise billing

Access the full letter here.


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3 hospital revenue cycle leaders predict how price transparency will affect healthcare

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