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AHA Senate Statement on What Can Congress Do to End the Medical Debt Crisis in America
Statementof theAmerican Hospital Associationfor the
Making Health Care More Affordable: Price Transparency and Eliminating āSurpriseā Billing
Just as there are challenges to making health care more affordable, there are many opportunities to reduce costs without compromising care. Hospitals are pursuing these opportunities in variety of ways. Many are tackling the affordability issue already, seeking change that makes sense for them and the communities they serve, and working to improve,Ā price transparency and eliminate āsurpriseā billing.
Surprise Billing
The No Surprises Act addresses surprise medical billing at the federal level. Most sections of the legislation go into effect on Jan. 1, 2022, and the Departments of Health and Human Services, Treasury, and Labor are tasked with issuing regulations and guidance to implement a number of the provisions.
Patient Billing Guidelines Affirmation
The American Hospital Associationās voluntary Patient Billing Guidelines outline how hospitals and health systems can best serve their patients and communities, and underscore their commitment to ensuring that conversations about financial obligations do not impede care, while recognizing that determinations around financial assistance require mutual sharing of information by providers and patients.
No Surprises Act Implementation Handbook
The No Surprises Act established new patient protections against balance billing in certain circumstances, as well as put into place a number of other provisions that will change how providers and health plans engage with patients and each other with respect to price and coverage transparency, as well as billing. The following implementation guide is intended to help hospitals and health systems understand the new provisions in the law and corresponding regulations.
Surprise Billing Principles
Americaās hospitals and health systems are committed to protecting patients from āsurprise billsā and support a federal legislative solution to do so. These types of bills may occur when a patient receives care from an out-of-network provider or when their health plan fails to pay for covered services.
Webinar: Implementing Regulations on Surprise Medical Billing: Part 3
A review the recently released interim final regulations implementing certain provisions of the No Surprises Act.
Surprise Billing Updates and Resources
The AHA supports protecting patients from surprise medical bills and improving patient access to meaningful pricing information. The following resources provide more information on the AHAās position, including in response to regulatory and legislative proposals.
Fact Sheet: Patients Should Not Settle for Subpar Patient Protections against Surprise Medical Billing
Hospitals and health systems are deeply concerned about the effect of unanticipated medical bills on our patients, which could impact their out- of-pocket costs. Protecting patients from surprise medical bills is a top priority for the AHA and all of our members. However, we oppose legislative proposals that set a default payment rate for out-of-network services. Recently, an agreement was announced that would address surprise medical bills. While no legislative language has been provided, we understand the proposal would include a prohibition on balance billing and rely on rate setting to establish an initial payment, with an opportunity for providers to dispute the payment.
Fact Sheet: Surprise Billing Legislation
The Senate and House are both considering legislation to address surprise medical bills that patients may incur as a result of unexpected gaps in insurance coverage or medical emergencies. Below are brief summaries of the proposals under consideration. A