House surprise-billing proposal passes committee with arbitration amendment

The House Energy and Commerce Committee passed legislation to end surprise medical bills July 17, with the addition of third-party arbitration.

The No Surprises Act — co-authored by Energy and Commerce Committee leaders Reps. Frank Pallone, D-N.J., and Greg Walden, R-Ore. — advanced out of committee as part of the Reauthorizing and Extending America's Community Health Act, with amendments. It now goes to the full House for a vote.

Under the legislation, healthcare facilities would be required to notify patients at least 24 hours before an elective treatment that an out-of-network provider would be involved in their care, according to NPR.

The bill would also prohibit healthcare facilities and providers from balance-billing patients for that care and would establish rates for payments from commercial health plans to providers based on the local market.

The initial No Surprises Act did not include a process for providers and payers to challenge the basic median reimbursement. But the amended version includes such a process for resolving certain out-of-network payment disputes.

“With this strong, bipartisan vote, the days of patients receiving financially devastating surprise health care bills are numbered," Mr. Pallone said in a news release. "The No Surprises Act will shield consumers from these outrageous billing practices while striking a fair balance between the stakeholders who have allowed this clear market failure to persist for decades at the patients' expense."

Senate surprise-billing legislation formally introduced June 19 by Senate Health Committee Chairman Lamar Alexander, R-Tenn., and ranking member Patty Murray, D-Wash., is also advancing. It passed the Senate health committee June 26, and Mr. Alexander said he hopes the full Senate will pass the bill and send it to President Trump for signing in July.

The Senate Lower Health Care Costs Act would require health plans to pay providers the local median contracted commercial amount.

Separately, the STOP Surprise Medical Bills Act introduced by Sen. Maggie Hassan, D-N.H., Sen. Bill Cassidy, R-La., and a bipartisan group of senators includes an independent dispute resolution process.


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