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S. 1531

STOP Surprise Medical Bills Act of 2019

Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019

This bill prohibits health care providers and health insurance plans from billing enrollees in excess of the in-network amount for specified health care services provided out-of-network. Specifically, a plan or provider may not charge an enrollee more than the in-network amount for services that are

  • emergency services provided by an out-of-network provider or at an out-of-network facility;
  • nonemergency services provided at an in-network facility by an out-of-network provider; or
  • nonemergency services provided out-of-network to an enrollee who initially enters through an emergency room for emergency services, except under specified circumstances.

Additionally, health insurance plans must pay the median in-network amount, minus the enrollee's in-network cost-sharing amount, directly to a health care provider. The bill also establishes an independent review process to resolve billing disputes between insurance plans and providers.

Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Sen. Cassidy, Bill [R-LA](R-LA)Sponsor
30 cosponsors14 D16 R
30cosponsors1committees2actions9subjects
  1. IntroReferral

    Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

    Health, Education, Labor, and Pensions Committee
  2. IntroReferral10000

    Introduced in Senate

STOP Surprise Medical Bills Act of 2019 — Informed