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A bipartisan group of senators is unveiling a draft measure to crack down on surprise medical bills, which they say have plagued patients with massive unexpected charges for care. The measure would prevent a health care provider that is outside of a patient’s insurance network from charging additional costs for emergency services to patients beyond the amount usually allowed under their insurance plan. (Sullivan, 9/18)

Kaiser Health News: Senators Unveil Legislation To Protect Patients Against Surprise Medical Bills

“Our proposal protects patients in those emergency situations where current law does not, so that they don’t receive a surprise bill that is basically uncapped by anything but a sense of shame,” Sen. Bill Cassidy (R-La.) said in his announcement about the legislation. Kevin Lucia, a senior research professor at Georgetown University’s Center on Health Insurance Reforms who had not yet read the draft legislation, said the measure was aimed at a big problem. “Balance billing is ripe for a federal solution,” he said. States regulate only some health plans and that “leaves open a vast number of people that aren’t covered by those laws.” (Bluth, 9/19)

The Senate's health committee on Tuesday questioned how the government should be involved in healthcare price transparency and whether Congress can change the incentives to encourage more patient shopping. It isn't clear what Congress could do legislatively to improve transparency. Sen. Lamar Alexander (R-Tenn.), chair of the Senate Health, Education, Labor and Pensions Committee, asked witnesses during Tuesday's hearing what federal mandates on the issue could look like for Medicaid and Medicare. They largely agreed that everyone in the system, from hospitals to physicians to the patients, need to know the actual price and need better access to quality data. But spelling that out through federal mandates could prove elusive. (Luthi, 9/18)

Last year, Cigna Corp. and the New York hospital system Northwell Health discussed developing an insurance plan that would offer low-cost coverage by excluding some other health-care providers, according to people with knowledge of the matter. It never happened. The problem was a separate contract between Cigna and NewYork-Presbyterian, the powerful hospital operator that is a Northwell rival. Cigna couldn’t find a way to work around restrictive language that blocked it from selling any plans that didn’t include NewYork-Presbyterian, according to the people. (Wilde Mathews, 9/18)