Surprise billing solution must protect patients, healthcare groups tell Congress

Two healthcare groups have penned a letter to Congress advocating  protection for patients against unexpected gaps in insurance coverage that can result in surprise medical bills.

Chip Kahn, president and CEO of the Federation of American Hospitals, and Rick Pollack, president and CEO of the American Hospital Association, said members of their organizations are committed to identifying a legislative solution to the issue.

"We strongly believe that any public policy solution to resolve surprise bills must protect patients by prohibiting balance billing and by limiting patients' cost-sharing to an in-network amount," the letter states.

The organizations told Congress they are working together to find solutions to challenges related to surprise billing. They said they are specifically examining issues such as "how we protect the broadest range of patients, including those in self-insured plans," and "how cost-sharing should be determined for out-of-network care so that patients have certainty about their financial obligations."

They said they are also looking at network adequacy requirements and enforcement, as well as whether policy interventions are needed to determine fair provider payment once protections for patients are in place.

The American Hospital Association and Federation of American Hospitals plan to provide policymakers with more specific feedback this year.


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