HHS Releases Report on Surprise Billing

Responding to a requirement in Executive Order 13877, “Improving Price and Quality Transparency in American Healthcare to Put Patients First,” on July 29, HHS released the “HHS Secretary’s Report on Addressing Surprise Billing.” Among other things, the report describes federal actions to encourage price transparency for medical services, summarizes pending federal legislation and describes what Congress and HHS have done to address surprise billing during the COVID-19 Public Health Emergency. The report calls for congressional action to eliminate the threat of surprise billing that follows the principles laid out by the Administration:

• Patients receiving emergency care should not be forced to shoulder extra costs billed by a care provider but not covered by their insurer;
• Patients receiving scheduled care should have information about whether providers are in or out of their network and what costs they may face;
• Patients should not receive surprise bills from out-of-network providers they did not choose; and
• Federal healthcare expenditures should not increase.

The report did not endorse any particular bill. Instead, it stated that legislation needs to be simple and fair for patients and not place implementation barriers on health plans and providers.

Before issuing the report, the White House floated a proposal to simply ban surprise medical bills without any corresponding process for resolving payment disputes been physicians and health plans. The AANS and the CNS oppose this approach and worked with members of the GOP Doc Caucus to send a letter to President Donald J. Trump. Expressing concerns about a straight ban on surprise medical bills, the Doc Caucus members noted that this approach “would have a disproportionately harmful impact on providers trying to negotiate fair rates with insurers for their services” and that providers “must have some mechanism to dispute unfairly low payments.”