U.S. Sens. Ron Wyden (-OR) and Bernie Sanders (I-VT) are asking federal agencies to issue guidance to insurers on cost-sharing practices that can result in surprise medical bills for patients.
The request follows recent news reports about individuals covered by private health insurance plans being hit with unexpected equipment and facility fees for preventative services that should be covered by their insurance.
Currently, certain preventative services are required to be covered with no cost-sharing by most private insurance plans. However, the lawmakers said that some insurance companies and providers abuse loopholes in regulations to pass unexpected fees onto patients’ medical bills.
“Health plans should be accountable for ensuring that preventive services are covered without cost sharing in accordance with the law. 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,” Wyden and Sanders wrote in a letter to the secretaries of Health and Human Services, Treasury, and Labor Departments.
Last year, Wyden made a similar request to the same federal agencies, urging them to ensure coverage for contraceptive products without cost-sharing fees.