No Surprises Act

Summary

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.

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Timeline

1. 12 June 2019

   Committee

   Hearings Held by the Subcommittee on Health Prior to Introduction and Referral.

   Source: Committee

2. 9 July 2019

   Introduced

   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.

   Source: IntroReferral

3. 9 July 2019

   Introduced

   Introduced in House

   Source: IntroReferral

4. 9 July 2019

   Introduced

   Introduced in House

   Source: IntroReferral

5. 10 July 2019

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

6. 11 July 2019

   Committee

   Forwarded by Subcommittee to Full Committee by Voice Vote .

   Source: Committee

7. 11 July 2019

   Committee

   Subcommittee Consideration and Mark-up Session Held.

   Source: Committee

Votes

No vote records are attached yet.

Versions

• Introduced in House · 9 July 2019 · Official file

Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 9 July 2019

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 9 July 2019

  ViewDownloadOpen at official source

• Introduced in House

  summary · EN · 9 July 2019

  Open at official source

Sponsors

• Rep. Pallone, Frank [D-NJ-6] · D · Sponsor
• GREG WALDEN · R · Sponsor
• Ann Wagner · R · Cosponsor
• Rep. Tlaib, Rashida [D-MI-12] · D · Cosponsor
• · hsif00 · Standing
• · hsed00 · Standing

Related records

No cross-record relationships stored yet.