Physicians Strongly Support House Effort to Protect Patients from Surprise Bills

ACEP Press Release:

Out of the Middle, a coalition of leading health care providers, applauds today’s introduction of the bipartisan Protecting People from Surprise Medical Bills Act. This is the only legislative framework before Congress that takes patients out of the middle of medical billing disputes, continues to ensure patients have access to health care services when and where they need them, and provides a level playing field for physicians and insurers.

The Protecting People from Surprise Medical Bills Act directly addresses the root cause of surprise bills—inadequate insurance networks—and includes robust patient protections such as making sure people only pay in-network amounts for care, whether the care provided was in- or out-of-network. The bill also makes it easier for patients to understand the limits of their insurance coverage, protects their choice of doctor and preserves access to planned and emergency care.

Once patients are protected, this bill goes further than other legislative proposals to encourage transparency from insurance companies and ensure fair and efficient dispute resolution between physicians and insurers. This independent process protects patients’ access to care, without adding cost, bureaucracy, or delay.

On behalf of the millions of patients we care for each day, Out of the Middle applauds the efforts of Representatives Ruiz, Roe, Bera, Morelle, Taylor, Bucshon, Shalala, and Wenstrup to protect Americans from surprise bills when their insurance coverage fails them.


Out of the Middle represents thousands of physicians across the country who are advocating on behalf of the millions of patients they care for every day and demanding Congress protect these patients from surprise medical bills without letting insurance companies dodge their responsibility to cover their care.

The coalition comprises the American College of Emergency Physicians, American Society of Anesthesiologists, College of American Pathologists, American Academy of Ophthalmology, American Association of Orthopaedic Surgeons, and the American Association of Neurological Surgeons and Congress of Neurological Surgeons.

For further information: Steve Arnoff | 202.370.9292 |

Patients Want Insurance Companies to Take More Responsibility for Surprise Bills, Poll Finds

ACEP Press Release:

As Congress debates how to best protect patients from surprise medical bills, a poll released today by Morning Consult finds more than eight in 10 Americans (81 percent) believe the responsibility for the costs associated with surprise billing lies with health insurance companies rather than hospitals and doctors.

Voters, especially those in smaller communities, are concerned about the effect of rate setting. Sixty-three percent of Americans are worried about the impact rate setting could have on small communities that already face hospital and doctor shortages, and an even higher percentage (67 percent) believe Congress must protect access to health care for the millions of Americans living in rural communities. When it comes to resolving payment disputes between insurers and providers, 69 percent prefer independent third-party resolution over allowing the government to set rates.

“The American College of Emergency Physicians (ACEP) stands with the majority of Americans in favor of independent dispute resolution, which takes patients out of the middle and establishes a fair, efficient process to resolve differences between insurers and providers,” said Vidor Friedman, MD, FACEP, president of ACEP. “Independent dispute resolution is a proven and market-based process that ensures that all stakeholders come to the table to negotiate in good faith.”

Other findings from the poll include:

  • Fifty-four percent of Americans with health insurance who experienced a surprise medical bill says it’s because their insurance company did not cover the medical treatment they received.
  • Eighty-one percent of Americans say that, given that in most emergency situations patients are not able to choose their provider, insurance companies should pay for emergency services.
  • Sixty-three percent of Americans support Congress stepping in to establish insurance network standards.

The poll was conducted by Morning Consult between May 31-June 1, 2019.

ACEP is the national medical specialty society representing emergency medicine. Through continuing education, research, public education and advocacy, ACEP advances emergency care on behalf of its 38,000 emergency physician members, and the more than 150 million Americans they treat on an annual basis.

SOURCE American College of Emergency Physicians (ACEP)

107 Rural Hospital Closures: January 2010 – Present

From UNC’s Shep Center (hat tip: Deb):

How do you gather information about closures?

We collect information from various sources, including web searches, news alerts, analyses of Centers for Medicare and Medicaid Services data, information exchange with the National Rural Health Association, the federal Office of Rural Health Policy, and from submission by the public.


How do you track closures?
Once we have identified rural hospitals at risk, we monitor them to gather information on why and when the will closure occur. We also monitor these facilities even after the closure occurred. Closed hospitals can re-open.
“closed but re-opened” hospital will appear on lists and maps produced for the public. These closures are usually identified by the assumption that there is no intent or action plan to re-open as a hospital at the time of closure. This closure would have previously been included in our count of closed rural hospitals at one point in the past.


Are rural hospital closures a new phenomenon?

No. Policymakers began paying attention in the late 1980s. The Office of Inspector General of the U.S. Department of Health and Human Services conducted a report in 1989 examining closures in 1987; because there was so much interest, the report was repeated on an annual basis for a few years. As the rate slowed in the late 1990s and early 2000s, interest waned until recently.


Country Closures: Rural Communities Adapt As More Hospitals Shut Down

From Ohio Valley Resource:

Ty Borders is the director of the Rural and Underserved Health Research Center at the University of Kentucky. He said access to health care is especially difficult for people in Appalachia.

“The reality is that many rural communities can’t really support a full-fledged hospital. They may need primary care and perhaps emergency department services, let’s say a primary care clinic attached to an emergency department.”

But federal policy complicates that simplified model for care.

“Medicare won’t pay for that,” Borders said. “Medicare will only pay for hospital or emergency department services that are in a hospital. And in most rural communities, that’s a critical access hospital.”

And those are the hospitals that are closing.