Disagreements create uncertainty on surprise-billing legislative fix

Lawmakers from both sides of the aisle agree patients should not be stuck with large, unexpected medical bills, but lobbying efforts and disagreements among lawmakers on how to address the issue have created uncertainty about whether a bill will make it to President Donald Trump this summer, according to The Wall Street Journal.

Multiple proposals to stop surprise medical bills are being considered in Congress. 

One of them, the Lower Health Care Costs Act formally introduced June 19 by Senate Health Committee Chairman Lamar Alexander, R-Tenn., and ranking member Patty Murray, D-Wash., passed in that committee June 26.

Mr. Alexander told The Hill he hopes the legislation goes before the full Senate for a vote by the end of July.

But the Senate proposal has sparked disagreements among lawmakers about how to settle insurer-provider payment disputes and whether hospitals or physicians should be on the hook financially, according to the Journal. At the same time, healthcare stakeholders are sparring over the best way to address surprise medical bills.

Mr. Alexander supports requiring health plans to pay providers the local median contracted commercial amount that health plans have negotiated with other providers and agreed to in the same geographic area.

While insurers support benchmarking, hospitals and physician groups support independent arbitration to settle disputes between insurers and providers.

In addition, a memo written by Paul Clement, a top Republican lawyer, argues the Senate's surprise-billing proposal may violate the First and Fifth Amendments.

Some congressional staffers told the Journal the brief could discourage some Republican senators from supporting the measure. 

Read the full report here


More articles on healthcare finance: 

Senate surprise-billing legislation could hurt medical transportation companies, S&P says
Michigan hospital updates upfront payment policy
U of Utah Health will no longer bill patients' surviving spouses for medical debt


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