If it pays off, this could be the biggest breakthrough of the year, vis-à-vis medical bills: movers and shakers in both the House and Senate have reached agreement on legislation to tackle surprise medical bills.
That’s according to The Hill, which reports that the progress comes in the form of an agreement among House Energy and Commerce Committee Chairman Frank Pallone Jr., D-NJ, Rep. Greg Walden, R-OR, who is the top Republican on that panel, and Senate Health Committee Chairman Lamar Alexander, R-TN.
Under the revised legislation, doctors would be prevented from sending unexpected bills to patients who receive treatment in a hospital that accepts their insurance. The legislation would also create a method to resolve related billing disputes between those doctors and insurance companies.
Slipped into the legislation are also provisions that would raise the tobacco age to 21 and increase drug pricing transparency.
According to the New York Times, “Doctors who provide care that is out-of-network for a patient’s insurance will automatically be paid the median price of in-network doctors in the area. For certain large claims, doctors will be allowed to appeal to an outside arbitrator for reconsideration.” Hospitals that treat patients in medical emergencies and air ambulances would get similar treatment.”
Alexander issued a statement saying, “I do not think it is possible to write a bill that has broader agreement than this among Senate and House Democrats and Republicans on Americans’ number one financial concern: what they pay out of their own pockets for health care.” Thus, it should come as no surprise that there is still room for agreement on details.
Doctors and hospitals are both hitting the lobby button hard over worries that the bill could result in them receiving less money. And it’s not known whether the comity over the arrangement currently being discussed will extend to other lawmakers who might be more closely allied with said doctors and hospitals.
In addition, Senator Patty Murray, the top Democrat on the Senate Health Committee, is not counted among the legislation’s supporters—at least not yet. Helen Hare, a spokeswoman for Murray, is quoted in the report saying, “Senator Murray believes the overall agreement takes important steps forward on a number of issues impacting patients and families, and is working with some members of her caucus on concerns they still have. “She didn’t want to sign onto a press release until those were worked through.”
The backers of a rival bill have withheld full-throated support for the agreement, although they issued a statement that is “generally supportive,” says the report. Senators Bill Cassidy, R-LA, Maggie Hassan, D-NH, and Michael Bennet, D-CO, have backed a different measure more to the taste of doctors. Their statement cautions that “final details” must be resolved before they can fully support it.
They released a statement saying, “As our discussions continue around the final details, we are encouraged that we’re one step closer to giving patients these vital protections. Patients have waited long enough, and we remain hopeful that we can get this done by the end of the year.”