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Lawmakers are introducing a bipartisan bill that could increase the maximum employer health plan penalty for a No Surprise Act claim payment delay to $10,000, from $100 today.
The bill would also require federal officials to send annual reports for Congress on what regulators are doing to verify insurer and health plan compliance with the No Surprises Act.
Rep. Greg Murphy, R-N.C., introduced the House version of the No Surprises Act Enforcement Act bill Wednesday.
Murphy's version has three Democratic cosponsors and two Republican cosponsors.
Sen. Roger Marshall, R-Kan., is introducing the Senate version of the bill together with Sen. Michael Bennet, D-Colo.
Murphy, Marshall and three of the House cosponsors are medical doctors.
The No Surprises Act: The No Surprises Act is supposed to require health coverage providers and health care providers to protect patients with health coverage against "balance billing," or extra bills, when the patients seek emergency care, or when patients seek care from in-network hospitals and end up receiving services from out-of-network radiologists or other out-of-network providers.
The act now imposes a maximum penalty of $10,000 on a provider that sends a patient a bill in violation of the act.
Insurers and health plans face fines of up to $100 per violation per day.
Perspectives: Providers argue that they need protection against plans that push for unrealistically low rates.
Employer groups like the ERISA Industry Committee say some providers are using No Surprises Act processes to drive up claims at a time when health plan costs are surging.
Related: The hidden traps in high-cost cardiology claims
Murphy and Marshall are siding with the providers.
"Big insurance companies have not been held accountable for paying what they owe," Murphy said in an announcement about the bill introduction.
"Our legislation ensures that out-of-network medical bills are resolved promptly and fairly, with enhanced penalties for any failure by the health insurers to do so," Marshall said.
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