[20190415]LSB10284_余额计费：当前的法律形势和拟议的联邦解决方案.pdf

CRS Legal Sidebar Prepared for Members and Committees of Congress Legal SidebarLegal Sidebari i Balance Billing: Current Legal Landscape and Proposed Federal Solutions April 15, 2019 As several recent reports have publicized, some patients covered by private health insurance continue to receive surpriseand often surprisingly highmedical bills resulting from treatment by out-of-network providers. Through a practice known as “balance billing,” an out-of-network provider bills the patient for charges that exceed her health insurance plans payment for a covered service. These bills are often surprising to the patients because they had received out-of-network care involuntarily or unknowinglysome were receiving emergency care and therefore had no choice in providers, while others unknowingly received care from such providers at an in-network facility. Several states have enacted legislation that would prohibit providers from balance billing the patients while also addressing the key underlying questionwho should pay for the care provided and how much to pay. A number of proposals introduced in the 115th Congress aimed to address the issue at the federal level and additional proposals ma