AMA, industry groups urge Congress to act on surprise billing

The American Medical Association has joined forces with 110 other healthcare industry groups representing hundreds of thousands of physicians to urge Congress to find a balanced approach to surprise medical billing legislation.

The topic of surprise billing has recently come up in Congress as policymakers have begun discussing possible legislative solutions to end the practice. Surprise medical billing happens when patients receive unanticipated medical bills weeks or months after a health visit. These bills often point out gaps in health insurance coverage and can be costly to patients who may not be able to afford them.

Surprise billing has come under the spotlight thanks to numerous news articles highlighting sky-high bills and patients on the hook for thousands––or even hundreds of thousands––of dollars for bills they didn’t know they were getting.

The letter from healthcare groups specifically points out that if legislation is titled toward insurers, rural areas and other underserved communities will likely see staffing shortages. Any surprise medical billing legislation should ensure that patients are protected from out-of-network services without their knowledge.

Beyond that, the groups noted that legislation cannot create new imbalances in the private insurance marketplace. The letter also took issue with several specific provisions in one bill currently being considered, the No Surprises Act.

“We are highly concerned that the rate-setting provisions in current bills further shift marketplace leverage to health insurers at the expense of providers,” the letter reads. “As a consequence, this imbalance will likely lead to access problems for patients seeking hospital-based care from on-call specialists, as well as precipitate staffing shortages in rural areas and other underserved communities.”