II 

117TH CONGRESS 

1ST SESSION S. 2411 

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

IN THE SENATE OF THE UNITED STATES 

JULY 21, 2021 

Ms. SMITH (for herself 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 2021’’. 

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. PRICING OF DIAGNOSTIC TESTING. 

15 Section 3202 of the CARES Act (Public Law 116– 

16 136) is amended— 

17 (1) in subsection (a)— 

18 (A) by amending paragraph (1) to read as 

19 follows: 

20 ‘‘(1) With respect to such items and services 

21 provided by a participating provider, such plan or 

22 issuer shall reimburse such provider the rate that 

23 the health plan or issuer has negotiated with such 

24 provider before the public health emergency declared 


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1 under section 319 of the Public Health Service Act 

2 (42 U.S.C. 247d) with respect to COVID–19.’’; and 

3 (B) by amending paragraph (2) to read as 

4 follows: 

5 ‘‘(2) With respect to such items and services 

6 provided by a nonparticipating provider or facility, 

7 such plan or issuer shall reimburse such provider in 

8 an amount equal to the lesser of— 

9 ‘‘(A) the cash price for a diagnostic test 

10 for COVID–19; or 

11 ‘‘(B) 2 times the reimbursement rate for 

12 the applicable items and services under the 

13 Medicare program under title XVIII of the So14 cial Security Act (42 U.S.C. 1395 et seq.).’’; 

15 (2) in subsection (b)(2), by striking ‘‘$300’’ 

16 and inserting ‘‘$10,000’’; and 

17 (3) by adding at the end the following: 

18 ‘‘(c) NO CHARGES FOR COVID–19 TESTING.—A 

19 provider shall not bill, and shall not hold liable, any indi20 vidual receiving items and services described in section 

21 6001(a) of division F of the Families First Coronavirus 

22 Response Act (Public Law 116–127) for a payment 

23 amount for such an item or service furnished by such pro24 vider.’’. 


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1 SEC. 4. IMPROVEMENTS TO TRANSPARENCY POLICY. 

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

3 (Public Law 116–136), as amended by section 3, is fur4 ther amended by adding at the end the following: 

5 ‘‘(d) IMPROVEMENTS TO TRANSPARENCY POLICY.— 

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

7 subsection, the Secretary of Health and Human Services 

8 shall survey a sample of providers of the items and serv9 ices described in section 6001(a) of division F of the Fam10 ilies First Coronavirus Response Act (Public Law 116– 

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

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

13 Secretary shall survey no fewer than 200 providers rep14 resenting a diversity of sizes, geographic locations, test 

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

16 and free-standing emergency rooms). 

17 ‘‘(e) PUBLIC REPORT.—Not later than 45 days after 

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

19 Health and Human Services shall publish a report on cash 

20 prices for items and services published under subsection 

21 (b)(1), which shall include— 

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

23 cash price publication requirement under subsection 

24 (b)(1); 

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

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


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1 the Families First Coronavirus Response Act (Public 

2 Law 116–127) and published under subsection 

3 (b)(1); 

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

5 a comparison of such average cash price to the reim6 bursement rate under the Medicare program under 

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

8 1395 et seq.); and 

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

10 subsection (b)(1) (including the names of the pro11 viders charging such prices) that substantially ex12 ceed the average cash price.’’. 

13 SEC. 5. GUIDANCE ON BILLING FOR PROVIDER VISITS AS14 SOCIATED WITH COVID–19 TESTING. 

15 The Secretary of Health and Human Services, the 

16 Secretary of Labor, and the Secretary of the Treasury, 

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

18 the date of enactment of this Act, for purposes of clari19 fying— 

20 (1) the process for submitting claims for items 

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

22 Families First Coronavirus Response Act (Public 

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

24 individual or group health insurance coverage or 

25 group health plans to whom such items and services 


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

2 authorization or other medical management require3 ments; and 

4 (2) that providers should not collect cost-shar5 ing amounts from individuals seeking items and 

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

Æ 


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