House health panel holds hearing on surprise billing: 5 takeaways

A House Ways and Means health subcommittee meeting shed light on disagreements among industry stakeholders regarding a legislative remedy for surprise medical bills, according to NPR.

Five takeaways:

1. Rep. Devin Nunes, R-Calif., ranking member of the subcommittee, said in his opening remarks: "I'm disappointed that all participants that are going to be here from critical sectors of our economy could not come to find a way to work together to protect patients from these huge surprise bills."

2. Providers and insurers blamed each other as they testified during the hearing, according to NPR.

3. Insurance groups such as the Blue Cross Blue Shield Association have expressed support for establishing a payment benchmark for out-of-network clinicians, such as emergency room physicians, as part of a legislative solution to surprise medical bills. However, groups such as the American Medical Association and American Hospital Association have asked Congress to consider dispute resolution methods, such as mediation and arbitration, as part of a legislative solution, and have expressed opposition to rate-setting policies.

4. At the May hearing, James Gelfand, senior vice president of health policy with the ERISA Industry Committee, which represents large health plan sponsors, called arbitration provisions, like the ones in a plan released by Sens. Maggie Hassan, D-N.H., Bill Cassidy, R-La.,  a "snipe hunt" used as a distraction from finding a solution to the issue, according to NPR.

5. Bobby Mukkamala, MD, an AMA board member, in testimony, said: "Proposals that use in-network rates as a guideline should be avoided. Setting payments at these discounted rates would further disrupt the increasing market imbalance favoring health insurers."

Read the full NPR report, including more about various legislative proposals, here.


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