Rep. Davids introduced legislation to combat surprise medical billing by requiring insurance companies to regularly update their directories, so people are aware of what their costs will be ahead of time.
Combat surprise medical billing by requiring insurance companies to regularly update their directories.
Occurrences
Evidence
Public Law 116-260 includes Division BB, Title I, cited as the No Surprises Act, with section 102 addressing surprise medical billing and section 116 titled protecting patients and improving the accuracy of provider directory information.
For plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer offering group or individual coverage must establish a verification process, response protocol, public database, and directory notice. The verification process must verify and update provider directory information not less frequently than once every 90 days and update the database within 2 business days after receiving provider or facility information.
Current U.S. Code states that for plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer must establish provider-directory requirements. It requires verification and updates of provider directory information at least every 90 days, a public website database, and protections limiting cost sharing when an enrollee relies on incorrect network information.
Current U.S. Code requires each health care provider and facility, beginning not later than January 1, 2022, to have business processes to timely provide provider directory information to group health plans or health insurance issuers, including when network agreements begin or terminate and when material changes occur.
On December 21, 2020, the House passed H.R. 133 on concurring in the Senate amendment with amendment except divisions B, C, E, and F by 359-53. The roll call lists Davids (KS), Democratic, Kansas, as voting Yea.
Congress.gov records H.R. 133 as the Consolidated Appropriations Act, 2021, in the 116th Congress and records final enactment as Public Law 116-260 on December 27, 2020.
CMS describes its No Surprise Billing initiative as ending surprise medical bills and says providers, facilities, plans, and issuers can use the site to comply with surprise billing protections and resolve out-of-network payment disputes.
Assessments
The promised outcome was enacted in federal law during Sharice Davids's first House term. Public Law 116-260, including the No Surprises Act, required group health plans and health insurance issuers to verify and update provider directory information at least every 90 days, maintain public databases, and protect patients who rely on inaccurate directory information. Davids voted yea on the House passage vote for H.R. 133 on December 21, 2020, and the law was enacted on December 27, 2020, while she was in office.