Private equity's role in surprise billing 'an enormous scam,' US congressman says

Leaders of the House Energy and Commerce Committee have sent letters to private equity firms that own physician staffing companies, highlighting their concerns about the role firms may play in surprise medical bills, according to The Hill

The letters are from Reps. Frank Pallone Jr. (D-N.J.) and Greg Walden (Ore.), who have worked together on bipartisan surprise-billing legislation, the No Surprises Act.  

Mr. Walden said he told MSNBC Live with Katy Tur about concerns he and Mr. Pallone have with private equity firms that are trying to influence decisionmakers in Congress.

"We're sending them a letter — Frank and I both are," said Mr. Walden. "We have evidence where they buy the practice, take the physicians out of network and raise the rates by 96 percent. Guess who is paying that? It's people like you and me and our constituents. Then they decide whether they get back into network, so this is an enormous scam, an enormous money drain on consumers. We want to be fair about the result. We want to hold harmless the consumer. We're open to having policy discussions about the best way to do that. We have a good compromise bill that's passed out of our committee unanimously, but you know, if they think they are going to intimidate us … in advertising attack ads that scare people falsely, they're making a big mistake."

The letters to three private equity firms seek information such as which physician staffing companies they own and the amount of money they receive from those companies, according to The Hill.

The letters come after The New York Times reported that physician staffing firms Envision Healthcare and TeamHealth, which are owned by private equity firms, appear to be involved in a secretive group that has launched an advertising campaign to stop surprise-billing legislation. The group calling itself Doctor Patient Unity is opposed to a surprise-billing fix of reimbursing providers based on federally set benchmark rates, and began running $28.6 million in ads in various states this year to relay its message.

An amended version of Mr. Pallone and Mr. Walden's No More Surprises Act passed the House Energy and Commerce Committee in July. The bill would establish rates for payments from commercial health plans to providers based on the local market to resolve out-of-network payment disputes.

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


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