WASHINGTON, D.C. — A bipartisan group of lawmakers introduced new legislation this week aimed at strengthening enforcement of the landmark No Surprises Act, citing concerns that insurance companies are circumventing patient protections designed to eliminate unexpected medical bills.
Congressman Greg Murphy, M.D. (R-NC), led the introduction of the No Surprises Enforcement Act in the House, joined by Representatives Jimmy Panetta (D-CA), John Joyce, M.D. (R-PA), Raul Ruiz, M.D. (D-CA), Bob Onder, M.D. (R-MO), and Kim Schrier, M.D. (D-WA). Companion legislation was introduced in the Senate by Senators Roger Marshall, M.D. (R-KS), and Michael Bennet (D-CO).
Insurance Companies Accused of Defying Current Law
The new legislation comes nearly five years after the original No Surprises Act was signed into law, with lawmakers arguing that major insurance companies have failed to comply with payment obligations under the existing framework.
“Although this historic legislation became law, big insurance companies have not been held accountable for paying what they owe,” said Congressman Murphy. “My bill cracks down on those that are willfully defying the law and doubles down on protecting patients.”
Senator Marshall echoed these concerns, describing the situation as “unbelievable” that health insurers would break the law while “unfairly punishing patients and providers.”
Enforcement Gaps Leave Patients Vulnerable
According to lawmakers, implementation of the 2020 No Surprises Act has fallen short of Congressional intent, with enforcement gaps allowing some providers and insurers to sidestep legal requirements.
“Gaps in the enforcement of the No Surprises Act have allowed some providers and insurers to sidestep the law and leave patients vulnerable to unexpected medical bills,” said Congressman Panetta.
Congressman Joyce, M.D., criticized the “deeply flawed” implementation, stating that current enforcement often “flagrantly ignores Congressional intent.”
Key Provisions of New Enforcement Legislation
The No Surprises Enforcement Act addresses identified weaknesses in the current system through three main mechanisms:
Enhanced Penalties: The legislation closes enforcement gaps by increasing penalties for non-compliance with statutory payment deadlines.
Equal Accountability: New provisions provide parity between penalties imposed on insurers and healthcare providers for violations of patient protection requirements.
Increased Transparency: The bill strengthens reporting requirements to improve oversight of compliance efforts.
Medical Professionals Support Stronger Enforcement
Several physician-lawmakers emphasized how current enforcement failures impact patient care, particularly in underserved communities.
“As an emergency physician, I’ve seen how delayed payments to providers hurt patients in underserved communities,” said Congressman Ruiz, M.D. “The No Surprises Act Enforcement Act will ensure accountability for both insurers and providers, so health officials can enforce the law effectively.”
Background on Original No Surprises Act
The original No Surprises Act, passed with bipartisan support in 2020, was designed to protect patients from unexpected out-of-network medical bills while establishing a balanced dispute resolution process between insurers and healthcare providers.
Senator Bennet, who introduced related legislation in 2019, noted the importance of ensuring continued compliance. “This legislation ensures that health care providers and insurance companies are upholding their obligations under that law,” he said.
The new enforcement legislation represents a continued bipartisan effort to address healthcare affordability concerns, with lawmakers from both parties emphasizing the need to protect families from unexpected medical debt while maintaining fairness across the healthcare system.
