surprise billing

December 24, 2019

Congress Continues to Develop Surprise Billing Legislation

On Dec. 11, the House Ways and Means Committee issued an outline of that panel’s bipartisan proposal for addressing surprise medical bills. Some details are vague, and it could be after the holidays before we see legislative language. Nonetheless, the committee’s approach offers significant differences from the recently issued agreement reached between the House Energy & Commerce Committee and the Senate Health, Labor, Education, and Pension (HELP) Committee. Like other proposals, the Ways & Means plan would limit patients’ out-of-pocket costs to the amounts they would have owed if they had the opportunity to choose in-network physicians and facilities to provide their care. An independent dispute resolution (IDR) system is also included.  However, unlike other proposals, Ways & Means does not restrict […]
July 30, 2019

U.S. Congress Takes Up Legislation Aimed at Addressing “Surprise Billing”

In July, the U.S. House of Representatives opened hearings and introduced legislation to address the issue of surprise billing entitled the “No Surprises Act” (H.R. 3630).  By July 17, the legislation had been subject to mark-up and amendments as well in the House Energy and Commerce Committee, which reported out the proposed legislation to the full House on a voice vote. An amendment offered by Rep. Raul Ruiz, MD (D-CA) and Rep. Larry Bucshon, MD (R-IN) was adopted to add an appeals provision. Appeals would be restricted to complex cases with a claim’s threshold of $1,250 (indexed to inflation). The threshold is designed to limit the number of appeals and thereby also retain a higher level of savings to offset the cost […]
June 25, 2019

U.S. Senate to Take Up Legislation Aimed at Addressing “Surprise Billing”

On June 18, a key Senate committee held hearings and says it is ready to start marking up a bill next week designed to contain healthcare costs. The wide-ranging legislative package on curbing healthcare costs is sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), the chairman and ranking member of the Health, Education, Labor and Pensions (HELP) Committee. Given the committee’s influence, and because this legislation has bipartisan support in the Senate where not many bills are moving, industry observers are taking the HELP panel’s proposal very seriously. The bill lays out three options for paying surprise medical bills but does not specify which path the final legislation should take. Advocates for each of the choices were among […]