STAT

Opinion: 3 legal challenges could derail out-of-network surprise medical bills

Litigation has played an important role in improving health and health care. What worked to reduce cigarette smoking in the U.S. could do the same for surprise medical bills.

Surprise medical bills have become the bane of many Americans who are seen in emergency departments. These bills arise because hospital-based physicians, who are mostly employed by private equity-owned staffing firms, decline to join insurers’ provider networks.

These doctors double dip by getting paid by insurers and then collecting a balance from patients. They also use their ability to bill out of network to negotiate higher fees when they do sign contracts.

Business and consumer advocates have focused on legislative solutions to this problem, but efforts in Congress have stalled.

I’m an advocate for people who need dialysis due to advanced kidney disease. A 2015 survey of our members found that 30% of those with commercial insurance had received at least one surprise bill.

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