Rep. Hern Introduces Legislation To Curb Dishonest Billing Practices In Healthcare

Oklahoma Rep. Kevin Hern presents a bipartisan bill to safeguard Americans from underhanded billing practices from healthcare providers. 

The rising cost of going to the doctor is putting a strain, not only on patients in Oklahoma and across the country, but also on the federal government, which is why a member of the state’s congressional delegation has introduced legislation to hold providers more accountable.

Hern (R-OK1), along with Rep. Annie Kuster (D-NH2), introduced the bipartisan measure last month. The Facilitating Accountability in Reimbursements–or FAIR–Act would clamp down on a practice Hern said has become increasingly common nationwide.

"Hospitals are buying up –- hospital complexes are buying up -- smaller practices, and then imposing the pricing that they charge at hospitals [at] these outpatient facilities,” Hern said in an interview Tuesday.

Hern said it is not illegal and he and Kuster are not trying to get in the way of the free market, but he says they are "working closely to ensure Americans are not deceived by dishonest billing.”

"It is time for Congress to identify government policies driving up cost and unhealthy market consolidation,” Hern said in a statement. “Requiring medical providers to adequately report their site of service will help Congress identify bad actors in the industry."

Hern said hospitals use their National Provider Identification (NPI) number at the newly acquired. off-campus medical practice to bill the government and private insurance at hospital rates.

"It could be a 100-200 percent increase overnight," Hern said, "which is driving up a lot of our charges to the Medicare program, and those are very important for us to get after and that’s what we’re doing in a bipartisan way."

The lawmakers say the FAIR Act would require that a hospital's off-campus outpatient practices all have separate NPI's by January 1, 2025 and would direct the Centers for Medicare and Medicaid Services to audit recently converted facilities to ensure they're meeting the 'remote location' of hospital facility requirements.

Hern said, the point is "to make sure that our seniors are being fairly charged and not being price gouged across America."