US Senator Bill Cassidy is working with a bipartisan collection of Senators to combat surprise medical billing with the STOP Surprise Medical Bills Act.  Cassidy says a care provider would be paid the cost difference between a patients in-network cost sharing and the median or average cost for the in-network rate for their services.

“But if the provider doesn’t like that, then they can go through an arbitration process with the insurer, but the patient is held harmless,” said Cassidy.

Scenarios in which patient balance billing occurs would be prohibited include emergency services and non-emergency services performed by an out of network provider at an in-network facility.

Cassidy says the legislation comes down to one principal.

“The patient should be the reason for the care, and not an excuse for a bill.  This legislation takes that principal and turns it into a practice,” said Cassidy.

The Act would also prohibit surprise billing non-emergency services following an emergency service at an out or network facility due to a patient not being able to be moved from the out of network facility.

Cassidy says he believes the legislation is finding a good fit for insurers and caregivers while addressing the concerns of lawmakers.

“This is a process.  We’re in negotiations.  We have been trying to take committee leadership’s concerns.  We think that we have got that sweet spot,” said Cassidy.