Surprise Medical Bill Moving in Congress Could Help Insurers As Well as Patients

Congress is closing in on a deal that could shield patients from surprise medical bills, eliminating a source of frustration for Americans who face unexpected charges from emergency care and other procedures. The question for the health-care industry is whether that fix might have broader implications for overall medical prices. The new proposal advanced last week by bipartisan committee leaders would remove patients from disputes among insurance companies, doctors, and hospitals. It would apply in emergencies and other circumstances where patients can’t avoid bills from physicians who don’t accept their insurance. In those situations, patients would have to pay only what they would owe to an in-network provider for the same service. Doctors, hospitals, and health insurers have millions of dollars at stake in how those disputed bills are resolved once patients are taken out of the middle.