Robust Enforcement & Closing Loopholes (Executive Action)

Why this works

• HHS (and the Dept.
• of Labor for employer plans) can issue clearer guidance or rules to streamline the IDR process so providers and insurers settle more disputes without arbitration.
• They can also increase penalties for any provider that tries to bill patients illegally.
• For example, setting up a well-publicized patient complaint system and then fining repeat offender hospitals or doctors will deter others.
• For ground ambulances, while waiting on Congress, the federal gov’t can encourage states to regulate them (perhaps tie Medicaid/Medicare funds to states adopting balance billing bans for ambulances).
• Also, CMS could require more price transparency from ambulance providers so patients can at least anticipate costs.
• On medical debt, CFPB needs to vigorously implement its rule – ensuring credit bureaus actually remove medical collections (CFPB will supervise them closely).
• Also, CFPB can use its powers to crack down on abusive medical debt collection practices (they already consider certain tactics unfair, but could update rules to e.g.
• prohibit suing on very old medical debts or requiring more verification before collections).
• HHS could update the requirements for nonprofit hospitals’ tax-exempt status to mandate generous charity care and ban them from placing liens on patients’ homes or garnishing wages if the patient is low-income – essentially force better behavior via IRS rule or guidance.