To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes.
Actions Overview (1)
Date
Actions Overview
07/09/2019
Introduced in House
07/09/2019 Introduced in House
All Actions (7)
Date
All Actions
07/11/2019
Forwarded by Subcommittee to Full Committee by Voice Vote . Action By: House Energy and Commerce Subcommittee on Health
07/11/2019
Subcommittee Consideration and Mark-up Session Held. Action By: House Energy and Commerce Subcommittee on Health
07/10/2019
Referred to the Subcommittee on Health. Action By: Committee on Energy and Commerce
07/09/2019
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. Action By: House of Representatives
07/09/2019
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. Action By: House of Representatives
07/09/2019
Introduced in House Action By: House of Representatives
06/12/2019
Hearings Held by the Subcommittee on Health Prior to Introduction and Referral. Action By: House Energy and Commerce Subcommittee on Health
07/11/2019 Forwarded by Subcommittee to Full Committee by Voice Vote .
07/11/2019 Subcommittee Consideration and Mark-up Session Held.
07/10/2019 Referred to the Subcommittee on Health.
07/09/2019 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
07/09/2019 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
07/09/2019 Introduced in House
06/12/2019 Hearings Held by the Subcommittee on Health Prior to Introduction and Referral.
Committees, subcommittees and links to reports associated with this bill are listed here, as well as the nature and date of committee activity and Congressional report number.
Committee / Subcommittee
Date
Activity
Related Documents
House Energy and Commerce
07/09/2019
Referred to
House Energy and Commerce Subcommittee on Health
07/10/2019
Referred to
06/12/2019
Hearings by
07/11/2019
Markup by
07/11/2019
Reported by
House Education and Labor
07/09/2019
Referred to
Related Bills (0)
No related bill information was received for H.R.3630.
This bill expands restrictions on charging health care plan holders out-of-network rates for certain services. First, the bill requires insurers offering plans that cover emergency services to bill plan holders no more than the median in-network rate for a particular emergency service, even if the service provider is out of network. The bill further prohibits insurers from billing plan holders more than the median in-network rate for nonemergency services provided by out-of-network providers at in-network facilities.
Out-of-network providers may not bill plan holders for the difference between the in-network and out-of-network rates for emergency services. The bill further prohibits out-of-network providers from billing plan holders for the difference in rates for nonemergency services provided at an in-network facility unless the provider complies with specified notice and consent requirements. Even when complying with these requirements, an out-of-network provider may not charge plan holders for the difference in rates for such nonemergency services if the provider is based at the in-network facility and is the only provider available to deliver the particular treatment or service at the facility.
The Department of Health and Human Services must provide grants to states to establish or maintain All Payer Claims Databases, which publish claims and payment information from insurers.
The bill also requires insurers to publish provider directories and requires the Government Accountability Office and the Department of Labor to report on certain issues related to the commercial health care market.
All Summaries (1)
Shown Here: Introduced in House (07/09/2019)
No Surprises Act
This bill expands restrictions on charging health care plan holders out-of-network rates for certain services. First, the bill requires insurers offering plans that cover emergency services to bill plan holders no more than the median in-network rate for a particular emergency service, even if the service provider is out of network. The bill further prohibits insurers from billing plan holders more than the median in-network rate for nonemergency services provided by out-of-network providers at in-network facilities.
Out-of-network providers may not bill plan holders for the difference between the in-network and out-of-network rates for emergency services. The bill further prohibits out-of-network providers from billing plan holders for the difference in rates for nonemergency services provided at an in-network facility unless the provider complies with specified notice and consent requirements. Even when complying with these requirements, an out-of-network provider may not charge plan holders for the difference in rates for such nonemergency services if the provider is based at the in-network facility and is the only provider available to deliver the particular treatment or service at the facility.
The Department of Health and Human Services must provide grants to states to establish or maintain All Payer Claims Databases, which publish claims and payment information from insurers.
The bill also requires insurers to publish provider directories and requires the Government Accountability Office and the Department of Labor to report on certain issues related to the commercial health care market.
