End Surprise Billing Act of 2019
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HR 861 — End Surprise Billing Act of 2019
Last action — Referred to the Subcommittee on Health.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed House
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4Passed Senate
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5To Executive
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6Enacted
This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
End Surprise Billing Act of 2019 This bill requires a critical access hospital or other hospital to comply, as a condition of participation in Medicare, with certain requirements related to billing for out-of-network services. With respect to an individual who has health benefits coverage and is seeking services, a hospital must provide notice as to (1) whether the hospital, or any of the providers furnishing services to the individual at the hospital, is not within the health care provider network or otherwise a participating provider with respect to the individual's health care coverage; and (2) if so, the estimated out-of-pocket costs of the services to the individual. At least 24 hours prior to providing those services, the hospital must document that the individual (1) has been provided with the required notice, and (2) consents to be furnished with the services and charged an amount approximate to the estimate provided. Otherwise, the hospital may not charge the individual more than the individual would have been required to pay if the services had been furnished by an in-network or participating provider. With respect to such an individual who is seeking same-day emergency services, a hospital may not charge more than the individual would be required to pay for such services furnished by an in-network or participating provider.
Bill Text
- Introduced Introduced in House Current html January 30, 2019
Compared against current U.S. Code AI-generated reading aid — verify against the official bill.
The bill amends the Medicare program to establish requirements for hospitals and critical access hospitals to prevent surprise billing practices.
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42 U.S.C. 1395cc
(Z) in the case of a hospital or critical access hospital, to adopt and enforce a policy to ensure compliance with the requirements of paragraphs (1) and (4) of subsection (l) and to meet the requirements of such paragraphs (relating to the prevention of surprise billing practices).
Adds a new requirement for hospitals to adopt policies that prevent surprise billing.
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42 U.S.C. 1395cc
(l) Requirement for Purposes of Preventing Surprise Billing.--
Introduces a new subsection outlining requirements for preventing surprise billing at hospitals.
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42 U.S.C. 1395cc
In case of noncompliance by hospitals and critical access hospitals.--In the case of an individual with health benefits coverage described in paragraph (1) who is furnished items or services by a hospital or critical access hospital (or provider of services or supplier furnishing services at such hospital or critical access hospital) that is not within the health care provider network or otherwise a participating provider of services or supplier with respect to such health benefits coverage of such individual, if the hospital or critical access hospital does not comply with the requirements of paragraph (1)...
Establishes penalties for hospitals that do not comply with the new surprise billing requirements.
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42 U.S.C. 1395cc
In case of same-day emergency services.--In the case of an individual with health benefits coverage described in paragraph (1) who is furnished items or services by a hospital...that is not within the health care provider network or otherwise a participating provider...on the same date on which the individual makes an appointment for such items or services...the hospital may not charge more than the amount that would have been required if the services had been furnished by a participating provider.
Limits charges for same-day emergency services provided by non-participating hospitals.
Action History
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Introduced in House
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Introduced in House
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Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
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Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
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Referred to the Subcommittee on Health.
Sponsors
- Lloyd Doggett · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
- Doggett, Lloyd Democratic
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HR 861 do?
- End Surprise Billing Act of 2019 This bill requires a critical access hospital or other hospital to comply, as a condition of participation in Medicare, with certain requirements related to billing for out-of-network services. With respect to an individual who has health benefits coverage and is seeking services, a hospital must provide notice as to (1) whether the hospital, or any of the providers furnishing services to the individual at the hospital, is not within the health care provider network or otherwise a participating provider with respect to the individual's health care coverage; and (2) if so, the estimated out-of-pocket costs of the services to the individual. At least 24 hours prior to providing those services, the hospital must document that the individual (1) has been provided with the required notice, and (2) consents to be furnished with the services and charged an amount approximate to the estimate provided. Otherwise, the hospital may not charge the individual more than the individual would have been required to pay if the services had been furnished by an in-network or participating provider. With respect to such an individual who is seeking same-day emergency services, a hospital may not charge more than the individual would be required to pay for such services furnished by an in-network or participating provider.
- Who sponsors HR 861?
- HR 861 is sponsored by Doggett, Lloyd (Democratic).
- What is the current status of HR 861?
- This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track HR 861?
- Track HR 861 free on One Click Politics — get push/email alerts when it moves.
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