(Washington, DC, Wednesday, April 6, 2022) – One in five insured Americans who have surgery or visit an emergency room will receive a surprise medical bill. Patients are usually billed the difference between what their insurance will cover and what an out-of-network provider like ambulances, lab pathologists, radiologists and anesthesiologists will charge. Physicians and hospitals can often bill patients for thousands of dollars.
With the passage of the No Surprises Act, bipartisan leaders in Congress took an important first step towards ensuring that patients and their families no longer need to worry about receiving a surprise medical bill from physicians and hospitals. The implementation of the law has been watched closely by industry stakeholders. That’s because the law included a dispute resolution process for physicians, hospitals, and health insurance to determine how much those care providers will be paid, since patients can no longer be billed.
However, six lawsuits have been filed across the country by physicians and hospitals to strike down all or part of the law. They want to be able to charge as much as they can. In one of those cases, Texas Medical Association v. HHS, U.S. District Court Judge Jeremy Kernodle ruled in favor of the Texas Medical Association, leaving the law and its patient protections in limbo. While litigation over major health care rules is common, providers have been particularly aggressive about challenging the No Surprises Act in court.
Health care providers are trying to pressure the Biden administration into altering the current interpretation in a way that they perceive as more friendly to their financial interests. By eliminating the protections of the No Surprises Act, patients and families will see higher premiums and higher out-of-pocket costs because of predatory price gouging. As lawsuits seek to undermine these important patient protections, the Coalition Against Surprise Medical Billing urges the Biden Administration to defend and implement the No Surprises Act.