The White House has issued a call to action to push lawmakers to address surprise billing.
President Donald Trump outlined on Thursday several principles that the administration hopes Congress adheres to as it builds legislation to address balance billing, which has become a hot-button health policy issue.
Surprise or balance bills most commonly occur in two scenarios, Joe Grogan, director of the Domestic Policy Council, told reporters on a call Thursday morning—when they are taken to a hospital in an emergency and are unable to choose an in-network facility, or when they have elective surgery and are treated unknowingly by an out-of-network physician, often an anesthesiologist or radiologist.
They’re then hit with pricey bills that are “not a pleasant surprise, a very unpleasant surprise,” Trump said.
“No American mom or dad should lay awake at night worrying about the hidden fees or shocking unexpected medical bills to come,” the president said.
The suggested guidelines include:
- Balance bills should be prohibited for emergency care.
- For voluntary services, patients should be provided upfront a clear bill that includes all out-of-pocket costs, including any associated with an out-of-network physician on the team.
- Patients should not receive a surprise medical bill if they did not choose a provider themselves.
- Any effort to address balance billing should not increase healthcare expenditures.
Legislators on both sides of the aisle have promised to take on surprise billing but have run into conflict with both the payer and provider lobbies on the best strategies for doing so. Bills haven’t really gotten off the ground as a result, though Sen. Lamar Alexander, R-Tenn., who chairs the Senate Health, Education, Labor & Pensions Committee, told Trump at the Thursday event that he can expect a bill potentially in July.
Though Trump did not offer any specific policy plans in his speech, senior administration officials did indicate on the call that some proposals are more appealing to the White House than others. For example, harnessing bundled payments to mitigate surprising billing for elective surgery is “of interest,” though the officials were less complimentary of arbitration.
New York uses an arbitration process to mitigate billing disputes. The administration officials said an arbitration approach could be a “distraction.”
Department of Health and Human Services Secretary Alex Azar said in a statement that pushing harder on surprise billing is in line with other consumer-oriented administration policies, such as a rule finalized yesterday to require drug prices in television ads.
“We aim to address surprise billing in a way that will protect American patients from this abusive practice and lay a foundation for a system where the patient is put at ease and in control,” Azar said.