Summary
In the attached chart, we provide side-by-side analysis of the major Congressional (Senate and House) legislation intended to protect patients from surprise medical billing that have been introduced/released 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 rates, 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:
- Stopping the Outrageous Practice (STOP) of Surprise Bills Act of 2019 (S. 1531) by Senators Bill Cassidy (R-LA), Michael Bennet (D-CO), Todd Young (R-IN), Maggie Hassan (D-NH), Lisa Murkowski (R-AK), Tom Carper (D-DE) and others.
- No Surprises Act (House Discussion Draft) by House Energy & Commerce Chairman Frank Pallone, Jr. (D-NJ) and Ranking Member Greg Walden (R-OR).
- End Surprise Medical Billing (House Legislative Outline) by Representatives Joseph Morelle (D-NY) and Van Taylor (R-TX).
We anticipate that additional proposals may take shape and evolve as this process moves forward in Congress. The Senate Health, Education, Labor and Pensions (HELP) Committee will soon release details on what they hope will be a bipartisan health care cost-containment package for a mark-up in June, which we expect will incorporate provisions addressing surprise medical billing alongside other health care cost issues.