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.
On the same day that air ambulance companies sued to block federal surprise billing protections from going into effect, new data from Brookings reinforces the blatant motive behind the suit. The analysis – Private equity-owned air ambulances receive higher payments,...
More than 60 Consumer and Patient Organizations, Union and Employer Groups Call on Biden Administration to Maintain Surprise Billing Protections, Limits on IDR Ahead of Jan. 1
In a new letter to the Biden Administration, more than 60 organizations – including AFL-CIO, AFSCME, American Benefits Council, Business Group on Health, Families USA, HR Policy Association, National Education Association, National Retail Federation, Purchaser...
Tell Washington it’s time to protect patients from surprise and unfair medical bills.