II 

116TH CONGRESS 

2D SESSION S. 4745 

To prevent surprise medical bills with respect to COVID–19 testing. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2020 

Ms. SMITH (for herself, Mrs. MURRAY, Mrs. SHAHEEN, Ms. HIRONO, Ms. 

HASSAN, and Ms. KLOBUCHAR) introduced the following bill; which was 

read twice and referred to the Committee on Health, Education, Labor, 

and Pensions 

A BILL 

To prevent surprise medical bills with respect to COVID– 

19 testing. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Stop COVID–19 Test 

5 Surprise Medical Bills Act of 2020’’. 

6 SEC. 2. MEDICAL MANAGEMENT. 

7 Section 6001 of the Families First Coronavirus Re8 sponse Act (Public Law 116–127) is amended by adding 

9 at the end the following: 


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1 ‘‘(e) MEDICAL MANAGEMENT.—For purposes of this 

2 section, the term ‘medical management’ includes deter3 minations about why an individual sought testing, the na4 ture of the clinical assessment that was associated with 

5 the testing, whether the individual was showing symptoms, 

6 what provider ordered the testing, the frequency of testing 

7 obtained by the individual, and other reviews of the en8 counters or events that proceeded or followed a service de9 scribed in subsection (a). Such term does not include rea10 sonable efforts by a group health plan or health insurance 

11 issuer to encourage individuals to obtain tests from lower 

12 priced providers (provided that such reasonable efforts do 

13 not delay or otherwise impede access to testing).’’. 

14 SEC. 3. IMPROVEMENTS TO TRANSPARENCY POLICY. 

15 (a) IN GENERAL.—Section 3202 of the CARES Act 

16 (Public Law 116–136) is amended by adding at the end 

17 the following: 

18 ‘‘(c) IMPROVEMENTS TO TRANSPARENCY POLICY.— 

19 Not later than 30 days after the date of enactment of this 

20 subsection, the Secretary of Health and Human Services 

21 shall survey a sample of providers of the items and serv22 ices described in section 6001(a) of division F of the Fam23 ilies First Coronavirus Response Act (Public Law 116– 

24 127) regarding the cash prices for such items and services 

25 as listed by the providers on a public internet website. The 


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1 Secretary shall survey no fewer than 200 providers rep2 resenting a diversity of sizes, geographic locations, test 

3 types, and care settings (such as hospitals, laboratories, 

4 and free-standing emergency rooms). 

5 ‘‘(d) PUBLIC REPORT.—Not later than 45 days after 

6 the date of enactment of this subsection, the Secretary of 

7 Health and Human Services shall publish a report on cash 

8 prices for items and services published under subsection 

9 (b)(1), which shall include— 

10 ‘‘(1) the compliance rate of providers with the 

11 cash price publication requirement under subsection 

12 (b)(1); 

13 ‘‘(2) the average cash price for each item and 

14 service described in section 6001(a) of division F of 

15 the Families First Coronavirus Response Act (Public 

16 Law 116–127) and published under subsection 

17 (b)(1); 

18 ‘‘(3) with respect to each such item and service, 

19 a comparison of such average cash price to the reim20 bursement rate under the Medicare program under 

21 title XVIII of the Social Security Act (42 U.S.C. 

22 1395 et seq.); and 

23 ‘‘(4) any outlier cash prices published under 

24 subsection (b)(1) (including the names of the proVerDate Sep 11 2014 03:26 Oct 17, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4745.IS S4745

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1 viders charging such prices) that substantially ex2 ceed the average cash price.’’. 

3 SEC. 4. GUIDANCE ON BILLING FOR PROVIDER VISITS AS4 SOCIATED WITH COVID–19 TESTING. 

5 The Secretary of Health and Human Services, the 

6 Secretary of Labor, and the Secretary of the Treasury, 

7 shall jointly issue guidance, not later than 30 days after 

8 the date of enactment of this Act for purposes of clari9 fying— 

10 (1) the process for submitting claims for items 

11 and services described in section 6001(a) of the 

12 Families First Coronavirus Response Act (Public 

13 Law 116–127) to ensure that individuals enrolled in 

14 individual or group health insurance coverage or 

15 group health plans to whom such items and services 

16 are furnished are not subject to cost-sharing or prior 

17 authorization or other medical management require18 ments; and 

19 (2) that providers should not collect cost-shar20 ing amounts from individuals seeking items and 

21 services described in section 6001(a) of such Act. 

Æ 


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