More on Policy and Legislation

White House Domestic Policy Council director warns hospitals to address surprise bills

Joe Grogan told listeners at the Federation of American Hospitals' annual conference to get on top of surprise bills or the government will step in.

Beth Jones Sanborn, Managing Editor

When Joe Grogan, director of the White House Domestic Policy Council, addressed attendees at the Federation of American Hospitals' annual conference in Washington, he had a stern warning for hospitals, according to a report from The Hill. Get on top of surprise bills, or the government will take the wheel.

Grogan stipulated that the administration hadn't yet settled on a solution to the problem, but did forecast that any policy or administrative action would bode more poorly for hospitals than if they came up with an answer themselves.

"You have to come up with a solution, or bad things could happen because you'll have policymaking being made by people that don't understand the system nearly as well as you," Grogan said, according to the report.

HIMSS20 Digital

Learn on-demand, earn credit, find products and solutions. Get Started >>


His warning is a dire sign to hospital leaders and the healthcare industry as a whole that the growing upset and ire over such bills has reached a level where action is inevitable. It is therefore up to hospitals and health systems to get out in front of the issue and draft policies that will address the issue and lessen the burden and stress on patients, but won't create onerous challenges for the sustainability of their systems.

In fact, The Hill reported that legislation to protect patients from these bills is viewed as one of the most likely bipartisan undertaking pertaining to healthcare this year. Some lawmakers are already seeking industry guidance and feedback, including Republican Senator Bill Cassidy from Louisiana and Democratic Senators Michael Bennet from Colorado and Maggie Hassan from New Hampshire.


The issue of surprise hospital bills slamming patients with unexpected debt has been a hot button issue, especially in recent months. In a joint letter to Congress, several hospital groups including the American Hospital Association, America's Essential Hospitals, Children's Hospital Association and others sent a joint letter to Congress urging them to address this issue and offered several areas they felt legislation had to specifically focus. First they asked that any legislation accurately define what a surprise bill is and when they occur.

Then they said a bill should focus on protecting patients financially, say in that patients should have certainty regarding their cost-sharing obligations, which should be based on an in-network amount. Providers should not balance bill, meaning they should not send a patient a bill beyond their cost-sharing obligations. Balance billing is something that has also been in the news of late, with the Zuckerberg San Francisco General Hospital coming under heavy fire for that very practice. City leaders stepped in and are drafting plan to correct the issue, and ordered the hospital to suspend balance billing as the plan was worked on.

The groups also said that any surprise bill legislation should ensure patient access to emergency care, preserve the ability of health plans and providers to negotiate appropriate payment rates, remove the patient from those negotiations, urge health plans, employers, providers and others to improve patients' health care literacy, especially about their benefits and finally, ensure patients have access to comprehensive provider networks and accurate network information.


"Any public policy should take into account the interaction between federal and state laws. Many states have undertaken efforts to protect patients from surprise billing. Any federal solution should provide a default to state laws that meet the federal minimum for consumer protections," the letter said.

Twitter: @BethJSanborn
Email the writer:

Air Jordan Horizon AJ13