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House Energy and Commerce Committee Advances Surprise Billing Legislation

On July 17, the House Energy and Commerce Committee favorably reported H.R. 3630, the No Surprises Act, which would protect patients from unanticipated medical bills in emergency cases and when medical services are rendered by an out-of-network provider at an in-network hospital. Prior to the full committee mark-up, on May 28, the CNS and the AANS submitted comments to committee leaders, offering suggestions on how to improve this bill.

Under the latest version of the legislation, which was incorporated into H.R. 2328, when a billing dispute arises between a provider and insurer, the payment rate is based on the median in-network rate for the area in which the service occurred. The initial payments in 2021 would be based on rates in place in 2019. Rates would be adjusted for inflation each subsequent year. The committee adopted an amendment from Reps. Raul Ruiz, MD, (D-Calif.) and Larry Bucshon, MD, (R-Ind.), allowing providers to appeal the payment rate to an independent dispute resolution (IDR) process for claims over $1,250. The CNS and the AANS supported this amendment and issued a press release expressing our support. Click here to watch the committee mark-up.