Mucarsel-Powell, Freshman Democrats Introduce Legislation to Protect Patients from Surprise Medical Bills
~ Legislation requires insurance companies to regularly update provider directories to prevent patients from unknowingly receiving out-of-network care ~
Washington, September 18, 2019
Tags: Health Care
WASHINGTON – Today, U.S. Rep. Debbie Mucarsel-Powell (FL-26), member of the Hispanic Caucus Health Care & Mental Health and New Democrat Coalition Health Care Task Forces, joined U.S. Reps. Cindy Axne (IA-03), Susie Lee (NV-03), Susan Wild (PA-7), Haley Stevens (MI-11), Abby Finkenauer (IA-01), Xochitl Torres Small (NM-2) and Chrissy Houlahan (PA-6), in introducing legislation to protect Americans from “surprise bills” due to out-of-date insurance directories. The UPDATE Act requires insurance companies to regularly update their provider directories to prevent patients from unknowingly receiving out-of-network care.
“No American should suffer a surprise medical bill, yet far too often patients are left with a surprise bill because a care provider may have been out of network. This can occur even when a patient has contacted their insurance company beforehand exactly to avoid a surprise bill as insurance plans often have outdated records,” said Mucarsel-Powell. “Today, 40 percent of Americans would struggle to cover a $400 emergency expense, and this legislation will make sure insurance companies are updating their directories and providing beneficiaries with accurate information, so patients aren’t hit with a crippling surprise bill.”
Patients consult with insurance provider directories to confirm which doctors and services are in-network. Currently, insurance companies are not legally required to update their directories with accurate network information. As a result, patients across the country receive what they believe to be in-network care, only to be surprised with exorbitant out-of-network bills. The UPDATE Act will require insurance companies to check with a provider if they have not received a bill from them in the last six months in order to identify if that provider has gone out of network. If a provider has gone out of network, the legislation requires the insurance companies to update their directory information.
“Patients should be able to trust that when their insurance company tells them a provider is in network, they won’t get hit with a surprise out-of-network bill,”said Axne. “Middle-class families can’t afford to pay hundreds or thousands of dollars in surprise medical bills because an insurance company didn’t update their website. This common-sense legislation puts the onus on insurance companies to ensure patients are making medical decisions based on accurate information.”
“Health care in this country is already expensive enough, and for any person to receive a surprise bill from a provider that they were led to believe is in their network is a burden that no American deserves,” said Susie Lee. “This is an issue that Democrats and Republicans should agree needs to be fixed. I am proud to help introduce this bipartisan bill with Congresswoman Axne as I continue to fight to give every southern Nevadan and every American access to affordable, quality health care.”
“Too many middle-class families in Michigan are facing financial ruin from unexpected and expensive medical bills,” said Haley Stevens. “The UPDATE Act will help protect families from surprise bills by preventing patients from being charged for out-of-network care due to out-of-date insurance directories. Insurance companies have an obligation to ensure their networks are up to date so that patients can make informed healthcare decisions for themselves and their families, without going bankrupt.”
“I am fighting every day to drive down healthcare costs and improve access for Iowans,” said Finkenauer. “Iowans expect honesty, and this bill will help provide that when they choose their healthcare by helping ensure they aren’t unknowingly going to providers that are out of their coverage network. I want to make sure Iowans don’t get hit with a larger bill than they expected, and that is something all of Washington should be able to work on together.”
“Seeking the healthcare you need shouldn’t come with a price tag you weren’t expecting. Surprise billing hurts the pocketbooks of hardworking families and part of the solution is addressing the inaccuracies consumers face when researching in-network providers. The UPDATE Act will help improve transparency of in or out-of-network status by requiring insurance companies to maintain their provider list as up-to-date as possible. By providing improved information to patients, families can better plan their upcoming medical costs and lessen the headache of an unexpected medical bill,” said Torres Small.
A recent study found that 10 percent of providers listed in insurance directories were either no longer in-network, or had never been in-network at all. Anotherrecent study showed that surprise billing is on the rise, having increased from a 32% likelihood a patient would receive a surprise bill in 2010, to 43% in 2016. The average cost of surprise bills is on the rise as well, increasing from $804 in 2010, to $2,040 in 2016.