A major win for patients: new surprise billing protections

On New Year’s Day, new consumer protections against surprise medical billing went into effect, essentially ending one of the most egregious practices in our country’s health care system. While you may have missed this news among all the fireworks and resolutions, it was the result of years of work in Congress and across the country to protect patients from unexpected expenses. 

Unfortunately, surprise medical bills are a far-too-common experience. I’ve heard from countless folks in our community who were hit with an unexpected bill — sometimes after what they thought was a routine appointment with an in-network provider. Often, these bills couldn’t come at a worse time. Nearly 20 percent of patients who visit an emergency room end up being treated by an out-of-network provider. During a medical emergency, the last thing you need is an expensive bill you never even saw coming.

These new consumer protections are a major win for patients across the country, but I know there’s much more to be done to lower health care costs for Kansans.

The stories that our neighbors, friends, and colleagues have shared run from frustrating to heartbreaking to just devastating. At a recent event with my office, Prairie Village resident Heather Rubesch shared how surprise bills cropped up throughout her entire, multiple-year fight against cancer. She would receive a biopsy at an in-network facility, only to have it processed — and billed in full — by an out-of-network laboratory. These events are often out of a patient’s control, adding confusion to financial burden.

That unexpected financial burden also often causes ripple effects, leading to housing instability, late payments on rent and utilities, and a much greater impact on overall well-being. Remember that while that’s happening, folks are usually dealing with the health situation that led them to seek care in the first place.

It was a proud moment when I finally voted to pass a major patient protection package in late 2020, which included my original legislation to promote insurer transparency along with other consumer protections. As of January 1, 2022, that legislation is in effect. Under this new law:

• People no longer have to worry that seeking emergency medical attention will lead to unexpected financial ruin. The new guidelines ban out-of-network billing for emergency services, regardless of where they are given.
• People no longer have to deal with the frustration of visiting an in-network facility and unknowingly receiving — and paying for — care from an out-of-network provider, like an anesthesiologist or assistant surgeon.
• Insurance plans are required to keep up-to-date lists of their in-network providers for patients to reference when making appointments. This piece came from my original legislation to ensure folks don’t accidentally seek out-of-network care.

These new consumer protections are a major win for patients across the country, but I know there’s much more to be done to lower health care costs for Kansans.

This term, I introduced original legislation to close a health insurance loophole that can lead to major unexpected costs for new parents, and I voted to cap the price of insulin at $35 per month. I’ve continued pushing to expand Medicaid in Kansas and to allow Medicare to negotiate for lower drug prices.

Each new year represents both endings and beginnings. This year, I am proud to have helped bring the end of many harmful medical billing practices and the beginning of more peace of mind for patients.

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