U.S. Rep. Brad Wenstrup (R-OH) introduced a bill last week that if enacted would help patients avoid surprise medical bills by improving the accuracy of health care provider directory information within a patient’s health insurance company network.
Rep. Wenstrup is an original cosponsor of the bipartisan H.R. 5807, legislation that was lead sponsored by U.S. Rep. John Larson (D-CT) on Feb. 7.
“Far too often, patients and their families don’t have access to the most accurate information before making an important medical decision and end up getting left with an unexpected out-of-pocket bill,” Rep. Wenstrup said. “That’s why I’m proud to join Congressman Larson in introducing bipartisan legislation that empowers patients facing medical choices.”
H.R. 5807 would require health care insurers to create a “Provider Directory” database, which would include all health care providers and facilities in an insurance plan’s network, according to a summary of the bill provided by Rep. Wenstrup’s office. The legislation would also establish a verification process to ensure that the directory’s information remains up-to-date as well as to develop protocols for how insurance companies respond to beneficiaries’ inquiries.
“Our bill ensures that patients have clear and up-to-date information about which doctors are in their health insurance network and establishes safeguards to ensure patients can access this information in a timely fashion,” Wenstrup said.
Lastly, the bill would require providers to notify insurers when they are entering or exiting a network as well as when material changes to directory information, such as address and phone number, occur. Providers who fail to comply will be subject to a civil monetary penalty.
“Dealing with medical issues is stressful enough, patients and families shouldn’t have to worry about receiving surprise medical bills when seeking treatment,” Rep. Larson said. “This legislation puts patients first.”