Consumer Protections Against Surprise Medical Bills Act of 2020

8/10/2022, 11:27 PM

Consumer Protections Against Surprise Medical Bills Act of 2020

This bill makes a series of changes related to health care costs and billing practices. Among other things, the bill

  • applies the in-network cost-sharing amount to certain emergency and related nonemergency services that are provided out-of-network,
  • applies the in-network cost-sharing amount to nonemergency services that are provided out-of-network at an in-network facility unless specified written notice requirements are met,
  • establishes procedures for health insurance plans to negotiate reimbursement amounts paid to out-of-network providers in states without such a process,
  • requires insurance plans to establish publicly available databases that list the contact information for in-network providers and facilities,
  • requires health care providers and insurance plans to provide certain cost estimates for services scheduled at least three days in advance,
  • requires plans to continue benefits for specified long-term care when an insurance plan's contractual relationship with a provider or facility changes or terminates,
  • requires insurance plans to include specified consumer assistance and benefits information on a plan holder's membership card and maintain certain price comparison tools for in-network services,
  • establishes reporting requirements related to air ambulance services,
  • establishes a temporary income tax deduction for specified expenses resulting from out-of-network and emergency services.
Congress
116

Number
HR - 5826

Introduced on
2020-02-10

# Amendments
0

Sponsors
+5

Cosponsors
+5

Variations and Revisions

2/10/2020

Status of Legislation

Bill Introduced
Introduced to House
House to Vote
Introduced to Senate
Senate to Vote

Purpose and Summary

Consumer Protections Against Surprise Medical Bills Act of 2020

This bill makes a series of changes related to health care costs and billing practices. Among other things, the bill

  • applies the in-network cost-sharing amount to certain emergency and related nonemergency services that are provided out-of-network,
  • applies the in-network cost-sharing amount to nonemergency services that are provided out-of-network at an in-network facility unless specified written notice requirements are met,
  • establishes procedures for health insurance plans to negotiate reimbursement amounts paid to out-of-network providers in states without such a process,
  • requires insurance plans to establish publicly available databases that list the contact information for in-network providers and facilities,
  • requires health care providers and insurance plans to provide certain cost estimates for services scheduled at least three days in advance,
  • requires plans to continue benefits for specified long-term care when an insurance plan's contractual relationship with a provider or facility changes or terminates,
  • requires insurance plans to include specified consumer assistance and benefits information on a plan holder's membership card and maintain certain price comparison tools for in-network services,
  • establishes reporting requirements related to air ambulance services,
  • establishes a temporary income tax deduction for specified expenses resulting from out-of-network and emergency services.
Alternative Names
Official Title as IntroducedTo amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and title XI of the Social Security Act to prevent certain cases of out-of-network surprise medical bills, strengthen health care consumer protections, and improve health care information transparency, and for other purposes.

Policy Areas
Health

Potential Impact
Accounting and auditing•
Alternative dispute resolution, mediation, arbitration•
Business records•
Child health•
Civil actions and liability•
Consumer affairs•
Emergency medical services and trauma care•
Government information and archives•
Government studies and investigations•
Health care costs and insurance•
Health care coverage and access•
Health care quality•
Inflation and prices•
Licensing and registrations•
User charges and fees•
Women's health

Comments

Recent Activity

Latest Summary4/10/2021

Consumer Protections Against Surprise Medical Bills Act of 2020

This bill makes a series of changes related to health care costs and billing practices. Among other things, the bill

  • applies the in-network cost-sharing ...

Latest Action2/12/2020
Ordered to be Reported in the Nature of a Substitute (Amended) by Voice Vote.