March 12,2024

NEWS: Wyden, Sanders Press Federal Agencies to Protect Americans Against Surprise Medical Bills

Letter to Secretaries of HHS, Treasury, and Labor Urge the Departments to Issue Guidance to Insurers to Protect Patients from Surprise Fees Under Cost-Sharing

Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., and Senate Health, Employment, Labor and Pension (HELP) Committee Chair Bernard Sanders, I-Vt., this week sent a letter to federal agencies requesting they issue guidance to insurers to crack down on cost-sharing practices that land patients with surprise medical bills after receiving preventative services.

Health plans should be accountable for ensuring that preventive services are covered without cost sharing in accordance with the law,” Wyden and Sanders wrote. “Patients should not have to appeal these charges and be deterred from seeking preventive services. We strongly urge the Departments to issue clarifying guidance to protect patients from being charged cost-sharing when they receive recommended preventive services and address inappropriate charges for  services that are integral to recommended preventive services. Further, we encourage the Departments to conduct, investigate and audit health insurers participating in the Federally Facilitated Marketplace and employer-sponsored plans to ensure that ACA preventive services are covered without cost-sharing.”

The letter to Secretaries of Health and Human Services, Treasury, and Labor Departments come after recent news reports of individuals covered by private health insurance plans being hit with unexpected out-of-pocket costs for equipment and facility fees for preventative services that should be covered by their insurance, as is required under the law.

Currently, certain preventative services are required to be covered with no cost-sharing by most private insurance plans, under which 150 million Americans are covered, but insurance companies and providers continue to abuse loopholes in regulations to pass unexpected fees onto patients’ medical bills.

Last year, Senator Wyden sent similar letters to the same federal agencies urging them to ensure coverage for contraceptive products without cost-sharing fees.

The letters can be found here.

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