Surprise medical bills have nearly tripled in cost and frequency since 2010. Approximately 39% of individuals covered by private health insurance have received a surprise medical bill within the past year. Of those who received an unexpected bill, half say the amount they were expected to pay was less than $500 overall. Thirteen percent say the unexpected costs were over $2,000. Two thirds of Americans are “very worried” (38%) or “somewhat worried” (29%) about being able to afford their own or a family member’s unexpected medical bills. More than three quarters of Americans want the federal government to take action to address the problem of surprise medical bills2.
The Pennsylvania State Nurses Association (PSNA), representing more than 224,000 registered nurses in Pennsylvania, wants to end the practice of surprise medical bills. PSNA supports S.1531 and the independent resolution process (IDR).
The STOP Surprise Medical Bills Act (S.1531) leverages a proven process known as the independent dispute resolution entity (IDR). This IDR process, which protects patients, is a transparent process utilizing an independent mediator to negotiate a fair resolution of the payment dispute.
Another bill, the Lower Health Care Costs Act (S.1895), does not protect patients. Known as “benchmarking,” S.1895 gives the government control in determining and setting commercial payment from insurers to providers. This jeopardizes patient care and threatens the viability of providers and hospital systems.
PSNA strongly encourages Congress’ legislative package to include the IDR process in ending surprise billing.
 Sun, E. C., Mello, M. M., Moshfegh, J., & Baker, L. C. (2019, August 12). Assessment of out-of-network billing for privately insured patients receiving care in in-network hospitals. JAMA Intern Med. doi:10.1001/jamainternmed.2019.3451
2 Pollitz, K., Rae, M., Claxton, G., Cox, C., & Levitt, L. (2019, June 20). An examination of surprise medical bills and proposals to protect consumers from them. Health System Tracker. Retrieved from https://www.healthsystemtracker.org/brief/an-examination-of-surprise-medical-bills-and-proposals-to-protect-consumers-from-them/