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No Surprises Act

USA116th CongressHR-3630| House 
| Updated: 7/11/2019
Frank Pallone

Frank Pallone

Democratic Representative

New Jersey

Cosponsors (3)
Greg Walden (Republican)Ann Wagner (Republican)Rashida Tlaib (Democratic)

Health Subcommittee, Energy and Commerce Committee, Education and Workforce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
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
Jun 12, 2019
Hearings Held by the Subcommittee on Health Prior to Introduction and Referral.
Jul 9, 2019
Introduced in House
Jul 9, 2019
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.
Jul 10, 2019
Referred to the Subcommittee on Health.
Jul 11, 2019
Subcommittee Consideration and Mark-up Session Held.
Jul 11, 2019
Forwarded by Subcommittee to Full Committee by Voice Vote .
  • June 12, 2019
    Hearings Held by the Subcommittee on Health Prior to Introduction and Referral.


  • July 9, 2019
    Introduced in House


  • July 9, 2019
    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.


  • July 10, 2019
    Referred to the Subcommittee on Health.


  • July 11, 2019
    Subcommittee Consideration and Mark-up Session Held.


  • July 11, 2019
    Forwarded by Subcommittee to Full Committee by Voice Vote .

Health

Aviation and airportsCivil actions and liabilityCongressional oversightEmergency medical services and trauma careEmployee benefits and pensionsGovernment information and archivesGovernment studies and investigationsHealth care costs and insuranceHealth care coverage and accessHealth facilities and institutionsHealth information and medical recordsHealth programs administration and fundingHealth technology, devices, suppliesHospital careTransportation costs

No Surprises Act

USA116th CongressHR-3630| House 
| Updated: 7/11/2019
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.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Jun 12, 2019
Hearings Held by the Subcommittee on Health Prior to Introduction and Referral.
Jul 9, 2019
Introduced in House
Jul 9, 2019
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.
Jul 10, 2019
Referred to the Subcommittee on Health.
Jul 11, 2019
Subcommittee Consideration and Mark-up Session Held.
Jul 11, 2019
Forwarded by Subcommittee to Full Committee by Voice Vote .
  • June 12, 2019
    Hearings Held by the Subcommittee on Health Prior to Introduction and Referral.


  • July 9, 2019
    Introduced in House


  • July 9, 2019
    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.


  • July 10, 2019
    Referred to the Subcommittee on Health.


  • July 11, 2019
    Subcommittee Consideration and Mark-up Session Held.


  • July 11, 2019
    Forwarded by Subcommittee to Full Committee by Voice Vote .
Frank Pallone

Frank Pallone

Democratic Representative

New Jersey

Cosponsors (3)
Greg Walden (Republican)Ann Wagner (Republican)Rashida Tlaib (Democratic)

Health Subcommittee, Energy and Commerce Committee, Education and Workforce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Aviation and airportsCivil actions and liabilityCongressional oversightEmergency medical services and trauma careEmployee benefits and pensionsGovernment information and archivesGovernment studies and investigationsHealth care costs and insuranceHealth care coverage and accessHealth facilities and institutionsHealth information and medical recordsHealth programs administration and fundingHealth technology, devices, suppliesHospital careTransportation costs