The order to the U.S. Department of Health and Human Services focuses on hospital billing.
As part of an executive order on “An America-First Health Care Plan,” the White House has directed the Secretary of Health and Human Services (HHS) to provide updated information on the Medicare.gov hospital compare website to inform beneficiaries of hospital billing quality. The information must be updated within 180 days of the order, which was issued on Sept. 24, 2020.
The updates to the website, according to the order, should include:
- Whether the hospital is in compliance with the Hospital Price Transparency Final Rule, effective Jan. 1, 2021;
- Whether, upon discharge, the hospital provides patients with a receipt that includes a list of itemized services received during a hospital stay; and
- How often the hospital pursues legal action against patients, including to garnish wages, to place a lien on a patient’s home, or to withdraw money from a patient’s income tax refund.
This is expected to be addressed in a rulemaking from HHS in the coming months and ACA International will be analyzing and weighing in on the proposal.
ACA and the Healthcare Financial Management Association Medical Accounts Receivable Resolution Task Force also addressed extraordinary collection activities after reconvening this year to update best practices for the fair resolution of patients’ medical bills and address financial assistance policies in response to the COVID-19 pandemic. A section in the best practices report on frequently asked questions addresses the basics of the account resolution process, working with account resolution business affiliates, steps to take when initiating certain collection actions and final disposition of unresolved accounts. Appendixes include a sample public health emergency financial assistance policy, relevant legal provisions, a glossary of terms and sample consent language.
Surprise Medical Billing
The White House executive order also addresses issues related to surprise medical billing.
As of July 2020, almost 30 states have enacted some level of surprise billing protection, with other states considering similar legislation.
In May 2019, President Donald Trump announced four principles to guide congressional efforts to “prohibit exorbitant bills resulting from patients’ accidentally or unknowingly receiving services from out-of-network physicians.”
The administration’s surprise billing principles include:
• Patients receiving emergency care should not be forced to shoulder extra costs billed by a care provider but not covered by their insurer.
• Patients receiving scheduled care should have information about whether providers are in or out of their network and what costs they may face.
• Patients should not receive surprise bills from out-of-network providers they did not choose.
• Federal health care expenditures should not increase.
Without congressional action on surprise medical billing thus far, the White House also issued Executive Order 13877, Improving Price and Quality Transparency in American Healthcare to Put Patients First, in June 2019.
HHS, as required by Executive Order 13877, issued a report on surprise medical billing regulatory actions and the need for congressional support in July 2020.
According to the report and statistics on surprise medical billing published by JAMA Internal Medicine, “41% of insured adults were surprised by a medical bill in the past two years and almost half of those, 19% received a surprise medical bill because the provider was out-of-network.”
“Congress needs to enact legislation now to protect patients from surprise billing. Sound surprise billing legislation will not only protect patients but will also encourage a fairer, patient-centered health care system,” the HHS report states.