House Ways and Means chief proposes new surprise-billing solution

Kelly Gooch - Print  | 

A committee leader in the U.S. House is proposing a new path forward on surprise-billing legislation, according to The Hill.

Federal lawmakers have been considering various proposals to end surprise medical bills that occur after patients unintentionally receive out-of-network care in emergency situations or at in-network hospitals. 

Insurance companies, hospitals and physicians agree that patients should not be on the hook for surprise out-of-network charges but haven't come up with a way to resolve payment disputes between insurance companies and physicians once the patient is protected. 

In a letter sent to Democratic House Ways and Means Committee members and obtained by The Hill, committee Chairman Richard Neal, D-Mass., proposes letting federal officials and key healthcare stakeholders figure it all out.

Mr. Neal proposed that HHS, the U.S. Labor and Treasury department and other interested parties come up with standards for rates for surprise bills and decide "how and if dispute resolution should be included, within certain predefined parameters that ensure healthcare costs will not increase from the process."

This process has already been successfully used in the healthcare context, most recently in Medicare for the clinical laboratory fee schedule improvements and for the design of the durable medical equipment payment system, Mr. Neal wrote.

"It is a structured process, allowing for the disagreements to be reached and finalized in a timely manner," he said.

The committee would then provide recommendations to the secretaries of federal agencies, who would publish a proposed rule with the opportunity for public comment. Stakeholders could weigh in during the public comment period.

Read the full letter here.

 

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