Federal surprise billing legislation starts to move

May 15, 2019

The pace of congressional efforts to address “surprise billing” is quickening. This week, House Energy and Commerce Committee leaders unveiled a discussion draft of a bipartisan proposal that would prohibit balance billing for all emergency services and hold patients responsible only for the amount they would have paid in-network.

Among its other provisions, the proposal would establish a minimum payment standard, set at the median contracted (in-network) rate for the service in the geographic area the service was delivered, according to a summary of the No Surprises Act published by Politico. In effect, this would be reference pricing, a concept hospitals have strongly opposed during the surprise billing discussions.

“We strongly oppose approaches that would impose arbitrary rates on providers,” AHA President Rick Pollack said in a statement. He added that the Energy and Commerce Committee’s approach would “remove incentives [for insurers] to contract with providers.”

The Committee is accepting comments on their draft proposal. Meanwhile, the House Ways and Means Health Subcommittee has scheduled a hearing on surprise billing for May 21.

In the Senate, the Health, Education, Labor and Pensions Committee is expected to release its draft of a surprise billing proposal before Memorial Day as part of a larger effort to hold down health care costs. Sen. Murray, the panel’s senior Democrat, has worked closely with Chairman Lamar Alexander (R-TN) to craft the plan.

Lawmakers hope to have legislation on the floor of the House and Senate before the August recess. (John Flink)


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