Battle over surprise bills keeps building

Doctors are warning lawmakers to not confuse patient advocacy with giving more power to insurance companies.

The top Republican and Democrat on the House Ways and Means Committee have been hesitant to embrace the surprise billing proposal and have been exploring separate legislation. (Photo: Shutterstock)

Providers, insurers and Democrats and Republicans can’t agree on a solution to surprise medical bills.

A bill approved unanimously by the House Energy and Commerce Committee would require health care providers to notify patients at least 24 hours before an elective treatment if the treatment is out-of-network.

However, the top Republican and Democrat on the House Ways and Means Committee, which has jurisdiction over taxes, have been hesitant to embrace the bill and have been exploring separate legislation.

Related: Private equity firms in the crosshairs of latest surprise billing inquiry

Late last month, Ways and Means Chair Rep. Richard Neal, D-Mass., suggested convening a group of stakeholders from the health care industry to try to craft a compromise. However, the ranking member on the committee, Rep. Kevin Brady, R-Tex., said he didn’t favor that approach.

“I have yet to see how that would work anywhere in what we’re trying to achieve for ending surprise medical billing,” Brady said, adding that he was open to an arbitration process that would allow providers to protest low reimbursements from insurer

Insurers support putting in place a system that would establish median benchmark rates for out-of-network charges. This would essentially cap what doctors could charge out-of-network patients.

Meanwhile, doctors are warning the nation’s lawmakers to not confuse patient advocacy with giving more power to insurance companies. A recent letter to Congress signed by the American Medical Association and scores of other state and national groups representing different medical professions implores lawmakers to be wary of unintended consequences.

“We are highly concerned that the rate-setting provisions in current bills further shift marketplace leverage to health insurers at the expense of providers,” says the letter. “As a consequence, this imbalance will likely lead to access problems for patients seeking hospital-based care from on-call specialists, as well as precipitate staffing shortages in rural areas and other underserved communities.”

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