Summary
We provide an updated side-by-side analysis of the major congressional legislation intended to protect patients from surprise medical billing that have been introduced thus far in the 116th Congress.
For each of the three proposals outlined below, the chart examines key provisions regarding prohibited balance billing scenarios, payment mechanisms, implications for plans and providers, cost-sharing implications for patients, interaction with state laws, transparency requirements, and other key policy features. Specifically, we look at:
- Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) advanced by the House Ways and Means (W&M) Committee;
- Ban Surprise Billing Act (H.R. 5800) advanced by the House Education and Labor (Ed & Labor) Committee; and
- No Surprises Act, incorporated as Title III in the Lower Health Care Costs Act (S. 1895) and agreed upon by Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) and House Energy and Commerce (E&C) Committee Chairman Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR)