Carper’s STOP Surprise Medical Bills Act Receives Support from Groups Representing Patients, Providers, and Payers

WASHINGTON, D.C. –The STOP Surprise Medical Bills Act currently has 21 Senate cosponsors, the largest support of any solution in Congress, and has also received positive feedback from advocacy groups representing patients, health care providers, and health insurers.

U.S. Senators Tom Carper (D-Del.), Bill Cassidy, M.D. (R-La.), Michael Bennet (D-Colo.), Todd Young (R-Ind.), Maggie Hassan (D-N.H.), Lisa Murkowski (R-Alaska), Dan Sullivan (R-Alaska), Sherrod Brown (D-Ohio), Kevin Cramer (R-N.D.), Ben Cardin (D-Md.), John Kennedy (R-La.), Bob Casey (D-Pa.), Joni Ernst (R-Iowa), Sheldon Whitehouse (D-R.I.), Mike Braun (R-Ind.), Bob Menendez (D-N.J.), Lindsey Graham (R-S.C.), Jacky Rosen (D-Nev.), Cindy Hyde-Smith (R-Miss.), Tina Smith (D-Minn.), and Rob Portman (R-Ohio) are cosponsoring the bill.


From Patient organizations: 

“We work every day with patients who have done everything right—have insurance, inquire about network status—but they’re still caught in the middle of a system over which they have no control. They still wind up with enormous surprise bills,” said Alan Balch, CEO of the National Patient Advocate Foundation (NPAF). “We are excited to see lawmakers working together to create a more fair system for patients and their families.”


Groups endorsing the NPAF’s position include:

• Alliance for Aging Research

• American Kidney Fund

• CancerCare

• Children’s Brain Tumor Foundation

• Cutaneous Lymphoma Foundation

• GO2 Foundation for Lung Cancer

• Mended Hearts

• Mended Little Hearts

• National Alliance on Mental Illness

• National Osteoporosis Foundation

• Partners for Better Care

• Prevent Cancer Foundation

• RetireSafe


 “This bipartisan proposal would ensure that no patient will ever again be subject to outrageously high ‘surprise bills’ as the result of a hospital visit,” said John Rother, President and CEO of the National Coalition on Health Care. “Americans should have confidence that they will be treated fairly the next time they visit an emergency room. The National Coalition on Health Care commends Senators Cassidy and Hassan for their leadership on this issue, and we urge swift consideration by the Congress. Health care is expensive enough without families being subjected to price gouging just when they are most vulnerable.”


From Providers:


“We are pleased that the bipartisan Senate working group has included in their compromise bill the only solution that has shown years of success at the state level in combating surprise billing,” said Dr. Sherif Zaafran, Chair of Physicians for Fair Coverage. “The independent dispute resolution (IDR) model levels the playing field for providers, hospitals, and health plans—and leaves the patient out of the middle of any pricing disputes. What that means for patients is they only pay their usual co-pay for out-of-network care and don’t have to worry about getting hit with an outrageous bill. We know that in states where IDR has been implemented, physicians, hospitals, and insurers—and most importantly the patients—say the law has successfully protected consumers while ensuring a fair process for all stakeholders.”

“…Among the different surprise billing proposals that have been offered in the Senate, we believe the “STOP Surprise Medical Bills Act” put forward by Senator Cassidy and the Bipartisan Price Transparency Working Group provides the best starting point to take patients out of the middle of billing disputes and establish a fair, efficient process to resolve differences between insurers and providers. While improvements can still be made, we believe the framework offered by Senator Cassidy should serve as the foundation of the Senate’s ongoing efforts to protect patients from surprise medical bills, and we encourage the HELP Committee and the Senate to build upon this bipartisan legislative proposal,” said the American College of Emergency Physicians (ACEP) and The American Society of Anesthesiologists (ASA) in a joint statement.


From Payers:


We commend this bipartisan group of Senators for coming together to protect American patients and consumers. We support solutions found in the STOP Surprise Medical Bills Act that protect patients, rely on the reasonable rates negotiated by the free market, and ensure networks can continue to play an important role in delivering high quality and lower costs. These are the kinds of solutions that will improve health and reduce health care costs for everyone,” said Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP).

A study from the Georgetown University Health Policy Institute reviewed the implementation of a similar law to address surprise medical billing in New York. New York’s law takes patients out of the middle of payment disputes between providers and plans and uses a “baseball-style” approach to settle payment disputes when the providers and plans cannot reach an agreement on their own.

The study found that state officials have seen a “dramatic” decline in consumer complaints about surprise medical billing since the law went into effect, that independent arbitrator decisions were essentially even between plans and providers, and that the vast majority of cases were resolved before needing to go to arbitration. The study points out that the state law does not cover ERISA plans, underscoring the need for federal action.