The Education and Labor Committee bill is being criticized for its lack of reliance on an outside arbiter, while the Ways and Means bill does use one—a popular move among doctors and hospitals.
The bipartisan effort to put an end to surprise medical billing–a task that on its face should have been quick and easy–just got even more complicated.
Last week saw the release of two different bipartisan proposals to tackle surprise billing, one from House Education and Labor Committee Chairman Bobby Scott, D-VA, and ranking member Virginia Foxx, R-NC and the other from House Ways and Means Committee Chairman Richard Neal, D-MA and ranking member Kevin Brady, R-TX. It remains to be seen which—if either—will attract enough support to make it through the lawmaking process.
Modern Healthcare reports that the Ways and Means Committee bill won the immediate support of the Federation of American Hospitals, while the American Hospital Association is still considering the matter. The bill, according to a release from the committee, would require "that patients receive a true and honest bill in advance of scheduled procedures" and "create[s] a more balanced negotiation process to encourage all parties to resolve their reimbursement differences before using the streamlined and fair dispute resolution process."
The Education and Labor Committee bill, on the other hand, is being criticized for its lack of reliance on an outside arbiter, while the Ways and Means bill does use one—a popular move among doctors and hospitals. The Hill reports that while both bills "set the payment rate based on the median payment for that service in the geographic area, with the option of going to arbitration for some high-cost bills," the former bill has come in for criticism from Representative Donna Shalala, D-FL, a former secretary of Health and Human Services.
According to Shalala, she and other lawmakers have concerns about the Education and Labor bill and she will support the Ways and Means bill unless the former is amended.
"I have problems with it because it's not balanced," Shalala says of the Education and Labor bill. "What I mean by that is the insurance companies are the big winners, the hospitals in my district and their employees get hurt and they're the largest employers in my district. I can't support a bill that will hurt the hospital workers in my district."
Neal countered Shalala's comments by saying it's important not to make hospitals angry. Of the Ways and Means bill, he said, "We think that it's a good foundation. We think that it's patients first. Everybody's got big hospitals [in their districts]."
House Energy and Commerce Committee Chairman Frank Pallone Jr., D-NJ, said last week that he thinks he can work with Ways and Means, but wants to make sure the final bill saves taxpayers money and does not raise premiums.
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Marlene Satter
Marlene Y. Satter has worked in and written about the financial industry for decades.
