Posts

NASH Takes First Position on Surprise Medical Bills

Congress should address surprise medical bills in a manner that protects patients from such bills and establishes a fair negotiating process between providers and insurers, the National Alliance of Safety-Net Hospitals declared in its first public statement about the surprise medical bill issue.

The statement, developed to coincide with NASH Advocacy Day in Washington, D.C. last week, explains that the biggest challenge in developing a means of addressing this problem is forging a solution that ensures that providers, including private safety-net hospitals, can negotiate adequate reimbursement for care they deliver outside of the provider networks of their patients’ insurers.

With this in mind, NASH encourages Congress to pursue a solution that follows four basic principles:

  • Surprise billing legislation should protect patients from surprise medical bills and balance billing for out-of-network services.
  • Insurers and providers should be required to negotiate, without a federal role or involvement, for payment for services provided to insured individuals by out-of-network providers.
  • Insurers should uphold the “prudent layperson standard” and provide emergency care for any condition that a prudent layperson would reasonably believe requires emergency care.
  • Federal policies should preserve rather than supersede existing state policies that meet federal minimum patient protections for insurance products that are within states’ jurisdiction.

Learn more from NASH’s new position statement on surprise medical bills.

NASH Advocacy Day

Friday September 20, 2019 is NASH Advocacy Day in Washington, D.C.

Today, leaders of private safety-net hospitals have traveled to the nation’s capital from across the country for NASH Advocacy Day, during which members will meet with members of Congress and congressional and committee staff to discuss federal health care policy issues that affect the ability of private safety-net hospitals to serve their communities.

For the occasion, NASH has introduced three new policy position statements:  on the importance of delaying Medicaid disproportionate share (Medicaid DSH) cuts, surprise medical bills, and the new federal regulation governing so-called public charges.  See the new position papers here.

In addition, the National Alliance of Safety-Net Hospitals is presenting its “Champion for Health Care Award” to Representative Joe Kennedy III (D-MA) for “his tireless advocacy of access to care for his constituents, the residents of Massachusetts, and all Americans.”  See the news release announcing the award here.

Surprise Medical Bills Lead Patients to Change Hospitals

Patients who receive surprise medical bills are more likely to change hospitals than those who do not, a new study has found.

According to an analysis of behavior by obstetrics patients,

…11 percent of mothers experienced a surprise out-of-network bill with their first delivery, and this was associated with an increase of 13 percent in the odds of switching hospitals for the second delivery, compared to mothers who did not experience a surprise bill.

The study found that this switching often paid dividends for those who switched:

Mothers who switched hospitals after a surprise out-of-network bill reduced their relative risk of receiving a second surprise medical bill by 56 percent, compared to mothers who did not switch after receiving their first surprise bill.

NASH staff recently met with staff of the Senate Health, Education, Labor and Pensions (HELP) Committee to share private safety-net hospitals’ views on this emerging issue.

Learn more about the implications for hospitals when they send surprise medical bills in the Health Affairs study “Consumers’ Responses to Surprise Medical Bills in Elective Situations.”