Congress Passes Hoeven-Cosponsored Measure to Ban Surprise Medical Billing

Senator Worked to Include Compromise Language in Year-End Legislation

BISMARCK, N.D. – Senator John Hoeven today issued the following statement after Congress passed legislation to ban surprise medical billing, similar to a bipartisan bill that Hoeven is cosponsoring, along with Senator Kevin Cramer. Further, Hoeven joined his colleagues in urgingSenate leadership to include this measure in the year-end legislation, which Congress passed last month.

“When facing an emergency, people may not have the time or ability to ensure that the care they receive is rendered by doctors and providers who are in their network, and may be surprised to see a bill afterwards with charges that greatly exceed the going in-network rate,” said Hoeven. “Our legislation replaces surprise billing with a negotiation and arbitration process between insurers and providers, protecting patients from unexpected costs that they could not have reasonably anticipated or controlled.”

Specifically, the measure that Hoeven worked to advance and pass: 

  • Holds patients harmless from surprise medical bills, including from air ambulance providers.
    • Patients are only responsible for their in-network cost-sharing amounts in emergency situations and certain non-emergency situations where they do not have the ability to choose an in-network provider.
  • Prohibits out-of-network providers from balance billing patients unless:
    • The provider gives the patient notice of their network status and an estimate of charges 72 hours prior to receiving out-of-network services.
    • The patient provides consent to receive out-of-network care.
  • Allows health care providers and insurers to resolve payment disputes without involving the patient, either through negotiation between the parties or an independent dispute resolution (IDR) process. 
  • Requires patients to only pay the in-network cost-sharing amount for out-of-network air ambulances, while providing a 30-day period between insurers and air ambulances to settle out-of-network claims. If parties cannot reach a negotiated settlement within 30 days, an IDR with an arbiter would resolve the issue.