White House Surprise Billing Initiative Could Make a Real Difference for Patients, Say Advocates
During a press conference today, President Trump outlined a plan to limit surprise medical bills for patients that would severely curtail patient out-of-pocket liability. Advocates at the National Patient Advocate Foundation (NPAF), who have long championed patient protections against surprise billing, applauded the White House’s plan as a “patients-first” proposal.
“We’ve become accustomed to lackluster proposals that still leave patients liable, whether we’re talking about transparency, billing or formularies. If any resulting legislation follows the parameters outlined by the president today, patients could finally experience relief from the constant onslaught of surprise medical bills,” said Caitlin Donovan, director of outreach and public affairs for NPAF.
Among the points highlighted by the White House today:
- No patient should be surprise billed for care received in an emergency setting;
- For scheduled care, patients should receive a clear and honest bill upfront;
- Patients should not receive bills from out-of-network providers they didn’t choose;
- Any resulting regulation should include all markets: group, individual or self-insured.
Patient advocates believe that these parameters should only be the beginning of a true reform that brings relief from the ongoing pricing escalation in the United States. Other reforms that advocates believe should be incorporated into any federal legislation include:
- Coverage in all clinical settings, rather than being limited to hospitals or other in-patient facilities
- Protection from ambulance and air ambulance rides, which are swiftly becoming a leading source of balance bills
- Limiting payment obligations for uninsured patients, who number an estimated 27 million Americans today
A patient who knows the expected out-of-pocket costs for a planned surgery—including whether the surgeon or anesthesiologist are in-network—can decide ahead of time to proceed with the surgery as planned while preparing for expected costs or negotiating a payment plan for those services. Conversely, patients may opt to seek out an available, in-network provider instead.
“The current push for transparency has made no real difference in the lives of patients. Right now, even when patients do everything right – have insurance, inquire about network status – they still are caught in the middle of a system over which they have no control,” said Donovan. “Using transparency as a protection rather than a flimsy market incentive is truly a step in the right direction.”