House Committees Consider Balance Billing Proposals

This past Tuesday and Wednesday, respectively, the House Ways & Means and Education & Labor Committees marked up their proposals on balance or “surprise” billing. As we reported on Monday of this week, the Ways & Means Committee proposal, the Consumer Protections Against Surprise Medical Bills Act (H.R. 5826), did not include a provision on ground ambulance services. The House Education & Labor proposal, The Ban Surprise Billing Act (H.R. 5800), however, included a provision to create a federal advisory committee to recommend restrictions on the ability of ground ambulance service providers and suppliers to balance bill. The Ways & Means Committee reported out H.R 5826 favorably by voice vote. While the Education & Labor Committee also reported out H.R. 5800 favorably, the vote was 30 to 13 as a block of its Committee members preferred the approach of the Ways & Means proposal on how to address balance billing for other providers. It is now up to House leadership to determine next steps on how the chamber will approach a final package on balance billing. While H.R. 5800 as reported out by the Education & Labor Committee still includes the provision on ground ambulance services, Chairman Scott (D-VA) and (more…)

Balance Billing Update

On Friday, the House Ways & Means and Education & Labor Committees released their respective draft proposals on balance or “surprise” billing. The Ways and Means Committee proposal, the Consumer Protections Against Surprise Medical Bills Act, does not include a provision on ground ambulance services, but the AAA is requesting language to clarify that non-emergency interfacility ambulance transports are not inadvertently covered under the bill. The proposal by the Education & Labor Committee entitled The Ban Surprise Billing Act, however, does include a provision that would restrict ground ambulance service suppliers from balance billing. The Ban Surprise Billing Act would create a federal advisory committee comprised of various federal agency, ambulance industry, insurance and consumer representatives to develop restrictions on balance billing. The Secretary of Health and Human Services would then promulgate regulations based on the recommendations of the advisory committee. The Education & Labor Committee is scheduled to mark-up their bill tomorrow, Tuesday, February 11, and the Ways & Means Committee will consider their legislation on Wednesday, February 12. The AAA has communicated to the Education & Labor Committee our concerns with including a provision on ground ambulance services in the bill and our objection to taking away the ability...

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House Energy & Commerce Subcommittee Takes Action on Balance Billing

On July 11, 2019, the House Energy and Commerce Committee Health Subcommittee held a markup in which they advanced 10 health care bills, including legislation on surprise/balance billing. This legislation, H.R. 3630, the No Surprises Act attempts to address out-of-network surprise medical bills. The AAA Government Affairs team has been in regular communication with the Energy and Commerce Committee and member offices leading up to the markup to ensure that the ground ambulance industry and AAA members were not negatively impacted by the legislation or any introduced amendments. Thanks to the attentive efforts of AAA members, staff, and consultants, there was no mention of ground ambulance during the markup of H.R. 3630, the No Surprises Act. While ground ambulance was not mentioned, Rep. Lujan (D-NM) highlighted the air ambulance transparency language that is included in the No Surprises Act and called for it to be strengthened further before this legislation is considered by the full Energy and Commerce Committee. Over the course of the markup, Subcommittee Chairwoman Eshoo (D-CA) thanked Rep. Lujan for bringing attention to the “extraordinary costs” associated with air ambulance. Rep. Ruiz (D-CA) then expressed his ongoing concerns regarding the balance billing provisions of the No Surprises...

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Update on AAA Legislative Priorities

The American Ambulance Association has been working hard to accomplish the legislative goals of the membership in the 116th Congress. The AAA would like to take this opportunity to provide an update on what we have accomplished thus far in the 116th Congress. Balance/Surprise Billing Balance/surprise billing is a hot button issue that recently came into the spotlight at the start of the 116th Congress. With the President’s announcement calling for Congress to pass legislation that would end surprise billing for patients, there has been an increase in Congressional action on the issue including introduced legislation, discussion drafts and hearings in all committees of jurisdiction. The AAA has been working tirelessly with the Congressional committees of jurisdiction to educate Members and staff on the unique characteristics of EMS systems and that it would be inappropriate to apply the same restrictions on balanced billing to ground ambulance services. The AAA has formed a working group comprised of AAA member volunteers that have worked on policy and messaging on balance billing. The working group has submitted comments to the Energy and Commerce Committee and Senate HELP committees advocating that the ambulance industry is unique from other stakeholders, and as such, should be looked (more…)

Member Update on Balance Billing

This morning Ruth Hazdovac and Aidan Camas of AAA staff and Kathy Lester, Esq, Healthcare Consultant to the AAA attended a briefing held by the House Energy & Commerce Committee on the issue of surprise/balance billing. At the briefing, staff for Chairman Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) announced that they would be releasing a bipartisan discussion draft, the No Surprises Act, which would “protect consumers from surprise medical bills and increase transparency in our health care system.” As of now, ground and air ambulances are NOT included in the discussion draft. However, the committee is asking for comments on ground and air ambulance and recommendations on how to provide relief to the consumer in this area. The AAA has a Balance Billing Work Group that is hard at work developing a policy recommendation that will work for our members. The House Ways and Means Health Subcommittee Chairman Lloyd Doggett also announced today that the Health Subcommittee will hold a hearing next week entitled “Hearing on Protecting Patients from Surprise Medical Bills.” AAA Staff will be at the briefing and provide a timely update to membership on any developments. The AAA team will be submitting comments and (more…)

Senators Release Draft Balance Billing Legislation

On Tuesday, September 18, 2018 Senators Bill Cassidy, M.D. (R-LA), Michael Bennet (D-CO), Chuck Grassley (R-IA), Tom Carper (D-DE), Todd Young (R-IN), and Claire McCaskill (D-MO) released draft legislation that aims to protect patients from surprise medical bills. The discussion draft (view the entire draft) of this proposed legislation tackles three main aspects of balanced billing: Emergency services provided by an out-of-network provider in an out-of-network facility Non-Emergency services following an emergency service from an out-of-network facility Non-Emergency services performed by an out-of-network provider at an in-network facility The discussion draft outlines legislation that would prevent balanced billing of patients for emergency medical services and instead require insurers to pay the difference between out-of-network and in-network costs. This discussion draft was likely fueled, in part, by some recent headlines highlighting extremely high bills received by patients. In his press release, Senator Cassidy references two stories in particular, one of a patient who received a bill of nearly $109,000 for care after a heart attack, and another of a patient who received a bill for $17,850 for a urine test. The AAA knows that balanced billing is a major issue for our members and will be monitoring this legislation closely. The AAA and (more…)

Statement for NBC Nightly News Balance Billing Story 3/9/18

Last night, NBC Nightly News with Lester Holt ran a segment on ambulance balance billing. Although provided with a brief one-paragraph statement in advance, they chose to use less than one sentence of it during the broadcast. We have reproduced our original statement below to provide additional context. For a better understanding of the forces driving the costs behind ambulance care, please see this recent longer media response by American Ambulance Association President Mark Postma. Video Story Original Statement Provided by American Ambulance Association Emailed to Eric Salzman on January 28, 2018 | Very brief due to TV news format Ambulance providers, both private and public, serve their communities with lifesaving on-demand mobile healthcare 24/7, regardless of patients’ ability to pay. Ambulance services are saddled with a high cost of readiness as they keep certified personnel, sophisticated technology, and costly medications ready round-the-clock. Medicare, Medicaid, and private insurance often reimburse ambulance services at rates below the costs of providing this care, endangering their ability to continue serving families in their time of extreme need. Ambulance services bill patients as a last resort: This necessity is driven by a complex combination of rising patient deductibles, reduced insurance coverage, and unfair contractual (more…)

Balance Billing: AAA EVP Maria Bianchi on WOSU Ohio

The American Ambulance Association continues to defend ambulance providers in the face of misunderstandings regarding balance billing. Today, AAA’s Executive Vice President Maria Bianchi provided context on WOSU’s All Sides with Ann Fisher. Maria called in during an interview with Melissa Bailey, author of the November 20 Kaiser Health News article to which association President Mark Postma recently responded. Maria’s comments helped listeners understand the complex reality of EMS funding. Listen on-demand now►