There has been a lot of movement throughout the country on the state level to prevent patients from receiving surprise medical bills when they receive unanticipated care from out-of-network providers while seeking care from in-network providers. For example, in 2018, Missouri passed such legislation, which banned surprise medical bills for patients who are treated by an out-of-network physician at an in-network emergency room.
Now, there is also a bill pending in Congress called the STOP Surprise Medical Bills Act. It would not only protect patients from receiving surprise balance bills when they receive emergency care from an out-of-network facility or provider but also in the following situations:
- receiving elective health care services from out-of-network providers at in-network facilities;
- receiving health care services at an out-of-network facility following emergency care and not being able to travel to a different facility without medical transport; and
- receiving out-of-network laboratory or imaging services ordered by an in-network provider at that provider’s office.
If this legislation passes, health care providers and/or health plans that violate these provisions would be subject to civil monetary penalties.
We recommend health care providers closely follow this bill as it makes its way through Congress. Future health care delivery is certainly leading to more transparency and price awareness by consumers.