Policymakers, stakeholders discuss surprise medical billing
Pictured, from left to right: Claire McAndrew, director of Campaigns and Partnerships, Families USA; L. Anthony Cirillo, board member, American College of Emergency Physicians; Molly Smith, vice president, Coverage and State Issues Forum, American Hospital Association; Jeanette Thornton, senior vice president, Product, Employer, and Commercial Policy, America's Health Insurance Plans; and Paul B. Ginsburg, director, USC-Brookings Schaeffer Initiative for Health Policy.
The USC-Brookings Schaeffer Initiative for Health Policy today convened a panel of policymakers and stakeholders, including the AHA, to discuss its newly released analysis detailing policy approaches to eliminate surprise out-of-network billing and propose solutions.
The AHA last month unveiled a set of principles to help inform the ongoing federal policy debate regarding surprise billing and protect patients from the three most typical scenarios: (1) a patient accesses emergency services outside of their insurance network, including from providers while they are away from home; (2) a patient has acted in good faith to obtain care within their network but unintentionally receives care from an out-of-network physician providing services in an in-network hospital; or (3) a health plan denies coverage for emergency services saying they were unnecessary. In addition, the AHA – along with the Federation of American Hospitals, America’s Essential Hospitals, the Association of American Medical Colleges, Catholic Health Association of the United States and Children’s Hospital Association – shared with key legislators a letter outlining its position using these principles as a guide.
Participating on today’s panel, Molly Smith, AHA vice president for coverage and state issues, said, “The AHA believes that all patients should have protection from surprise medical bills. Given the challenges at the state level, we now support a federal solution and have been working with federal policymakers on what that may look like.”