October 11, 2018

ACR Comments on Senate Surprise Billing Draft Legislation

On October 8, the American College of Radiology (ACR) submitted comments to the bipartisan Senate Health Care Price Transparency Working Group regarding draft legislation to address “surprise medical bills.”

A preliminary draft bill entitled “Protecting Patients from Surprise Medical Bills Act” was released in September by Senators Bill Cassidy, MD (R-LA), Michael Bennet (D-CO), Chuck Grassley (R-IA), Tom Carper (D-DE), Todd Young (R-IN) and Claire McCaskill (D-MO).

The ACR government relations staff prepared an extensive background report on the draft legislation. It was published in the September 29, 2018 edition of Advocacy in Action eNews. The article also provided an in-depth explanation of the various forms of “surprise bills” that the legislation seeks to eradicate.

The College’s official comment letter expresses concern with several concepts within the draft legislation including use of the phrase “surprise medical bills” instead of more accurate references to “surprise gaps in insurance coverage,” the lack of robust provider network adequacy standards, the federal ban on balance billing and aspects of the federal caps on reimbursement for physicians who provide patient care the insurer deems to be out-of-network.

The ACR expresses support for patients only paying in-network cost-sharing and the need for written consent prior to additional emergency room care after the beneficiary has been stabilized.

To date, there is no companion legislation under consideration in the House of Representatives. The bipartisan Senate Health Care Price Transparency Working Group remains steadfast in its commitment to introduce a revised version of the Protecting Patients from Surprise Bills Act in the coming weeks.

The likelihood of the forthcoming legislation passing the Senate is unclear, though the bill has already secured a strong collection of bipartisan original cosponsors. A condensed legislative calendar, the results of the impending midterm elections and uncertainty surrounding the key priorities that federal lawmakers will consider during the remaining months of the 115th Congress present considerable obstacles to the legislation being enacted into law before the end of 2018.

ACR’s government relations staff will continue to monitor the Protecting Patients from Surprise Bills Act. Questions may be directed to Chris Sherin, Director, Congressional Affairs at csherin@acr.org.