Stop Surprise Medical Bills
Millions of Americans receive a surprise medical bill every year, bankrupting families and raising health care costs for everyone, including employers and taxpayers.
Members of the Coalition Against Surprise Medical Billing, which represent accountable care providers, leading employer groups, unions and health insurance providers and the tens of millions of people they employ and serve each day, support meaningful solutions to end surprise medical billing that would:
- Protect patients and families from surprise medical bills sent by out-of-network providers.
- Maintain fair, market-based payments for out-of-network care.
- Help reduce health care costs for consumers and taxpayers by avoiding an arbitration process that adds unnecessary expense, delay and bureaucracy to the health system.
Millions of patients face surprise medical bills they did not expect at prices they cannot afford. While the majority of doctors and providers do their best to deliver fair, affordable care for patients and their families, there is a small but significant number of doctors and hospitals responsible for the vast majority of surprise billing.
When clinical specialists choose not to participate in health insurance providers’ networks – or if they do not meet the standards for inclusion – they often demand a blank check from patients for their services. The consequences are significant: financial stress, fighting a complicated, confusing bureaucracy, harassed by collection agencies, and often legal action for non-payment. And when a health insurance provider steps in on a patient’s behalf to cover the surprise medical bill, it raises premiums for everyone else.
Role of Private Equity
The growing presence of private equity-backed providers is becoming an all too common influence in the health system — and one of the leading drivers behind egregious surprise medical bills that bankrupt families across the country. Out-of-network providers backed by equity firms continue to exploit a market loophole that allow them to charge exorbitant rates at patients’ expense. View the Coalition’s latest advertising on the harmful tactics from private equity firms below and why this practice needs to stop for good. Past evidence indicates that private equity firms have previously overused and misused the arbitration process, similar to the one included in the No Surprises Act, to increase their payments from health insurance providers — and ultimately patients. As we have seen in states like Texas, New York and New Jersey, the arbitration process adds levels of bureaucracy and costs that patients ultimately bear in their premiums.
While Congress took a first step to protect patients from these surprise bills with passage of the No Surprises Act in 2020, it is more important than ever that implementation of the law adhere to the fundamental goals of making health care more affordable and understandable for patients and eliminating opportunities for abuse or misuse among out-of-network providers and private equity firms. Implementing the No Surprises Act must:
- Reduce health care costs by maintaining reasonable, market-based payments to out-of-network providers.
- Ensure broad protections against unfair, surprise medical bils by establishing clear definitions around the scope of services affected by the law.
- Avoid a cumbersome arbitration process that increases costs for patients, businesses and taxpayers.
Georgetown / Commonwealth Fund: Are Surprise Billing Payments Likely to Lead to Inflation in Health Spending?
By Jack Hoadley & Kevin Lucia “The federal No Surprises Act protects consumers from 'surprise' bills from out-of-network providers and also establishes a method to determine how much insurers will pay those providers. Establishing payment is critical to ensuring...
Washington, D.C. - The Coalition Against Surprise Medical Billing issued the following statement on the final surprise billing provisions included as part of the No Surprises Act: “Despite out-of-network providers and private equity firms trying once again to...
Employers, Unions and Health Insurance Providers: Surprise Billing Reforms Can’t Be A Gift To Private Equity
In a new letter to Congressional leadership, members of the Coalition Against Surprise Medical Billing urged policymakers to prioritize critical “changes to the current bill that would lower costs for consumers, employers and taxpayers.” Highlights are included below:...
Tell Washington it’s time to protect patients from surprise and unfair medical bills.