The Issue

We’re Advocating for Real Change

The Challenge

  • Insurance networks are narrowing and coverage is being reduced
  • Consumers’ out-of-pocket expenses are increasing
  • Reimbursements are going down
  • The cost of care is going up

It’s Unsustainable — For Patients, For Physicians, For our Nation’s Health Care System

The Goal

PFC wants to End The Surprise Insurance Gap and improve patient protections by achieving passage of legislation that:

  • Alleviates surprise medical bills and provides greater transparency of pricing and coverage;
  • Creates an appropriate and fair Minimum Benefit Standard for out-of-network services that establishes a charge-based reimbursement schedule (meaning 80th percentile) connected to an independently recognized and verified database;
  • Allows the patient to initiate the mediation process with resolution required within 30 days;
  • Permits clinicians to initiate the mediation process and to bundle claims in doing so; and
  • Prevents insurance carriers from providing false, misleading and/or confusing information.

PFC’s Advocacy Campaign will take the fight to each state with proactive model legislation. Working hand-in-hand with local physician groups, consumers and others, we will build coalitions, engage grassroots, and implement a comprehensive, integrated public relations effort to educate and advocate.