Arthritis Foundation Issues Statement Urging Congress to Support Legislative Solutions to Surprise Medical Billing

The Honorable Mitch McConnell

U.S. Senate

317 Russell Senate Office Building

Washington, DC 20510

The Honorable Charles Schumer

U.S. Senate

322 Hart Senate Office Building

Washington, DC 20510

The Honorable Nancy Pelosi

U.S. House of Representatives

1236 Longworth House Office Building

Washington, DC 20515

The Honorable Kevin McCarthy

U.S. House of Representatives

2468 Rayburn House Office Building

Washington, DC 2051

ATLANTA, DECEMBER 16, 2020 - On behalf of the over 54 million Americans and 300,000 children with doctor-diagnosed arthritis in the U.S., the Arthritis Foundation applauds Congressional leadership in advancing crucial legislation on surprise medical billing. Arthritis is the #1 cause of disability in the U.S., and more than half of those individuals with a form of arthritis are over the age of 65. The Arthritis Foundation urges patient-centered reforms across the entire health care system to balance the need for patient access to therapies and lower out-of-pocket costs while instilling an innovative culture.

The Arthritis Foundation strongly urges policymakers to support and enact a bipartisan legislative solution to surprise medical billing, especially for patients undergoing procedures such as knee or hip replacements for degenerative osteoarthritis. Patients should be held harmless from both surprise medical bills and any disputes between the provider and insurance company. Numerous studies indicate that patients are often charged tens of thousands of dollars in surprise bills through no fault of their own. These practices are detrimental to patients and are unacceptable.

Often, we hear stories from our patients about unexpected medical bills, including from Arthritis Foundation Board of Director Dennis Ehling whose young adult son needed major back surgery. The family did their due diligence to specifically choose the doctors and hospital for the surgery to ensure it would be considered in-network; they also made sure everything was pre-authorized to avoid any surprises.

“We pre-cleared the surgery and all of the expenses with our insurance company,” said Ehling. “We were by my son’s side the entire time he was admitted. Throughout it all, no one ever mentioned that any of his treating doctors might not be in-network.”

A month later, the Ehlings received a bill from the hospital with an uncovered charge for an anesthesiologist who had stopped into the recovery room early in the morning for a post-surgery check-in.

“The anesthesiologist who made a simple check-in, for whom we had no notice and no choice, was out-of-network and, thus, we were initially billed more than $1,000 for that visit, before we were able to ultimately convince them to treat it as in network,” said Ehling.

The Arthritis Foundation recognizes the legislation is a strong compromise after years of negotiation on surprise medical billing and sees significant potential to protect patients.

“The Arthritis Foundation is committed to bringing awareness to the financial, physical and social impacts of arthritis, because so many people do not understand it. Our work is focused on improving the lives of arthritis patients by changing laws and getting life-changing research funded. We must make sure Congress takes it seriously,” said Ann M. Palmer, president and CEO of the Arthritis Foundation.

The time to act is now! Congress has an opportunity to pass a strong bipartisan solution, and we implore you and your colleagues to act quickly to ban surprise medical billing and fully protect patients in a legislative package.

If you have any questions or if helpful to discuss this crucial issue further, please contact Anna Hyde, Vice President of Advocacy and Access, at [email protected] .