Senate committee tackles surprise medical bills: 5 takeaways

The Senate Health, Education, Labor and Pensions Committee held a hearing June 18 on bipartisan legislation to end surprise medical bills.

Five takeaways:

1. The hearing came after Sen. Maggie Hassan, D-N.H., Sen. Bill Cassidy, R-La., and a bipartisan group of senators introduced the STOP Surprise Medical Bills Act May 16. It also came after Senate health committee Chairman Lamar Alexander, R-Tenn., and Ranking Member Patty Murray, D-Wash., released a discussion draft of the Lower Health Care Costs Act May 23. 

2. The STOP Surprise Medical Bills Act includes an independent dispute resolution process, giving healthcare providers and health plans the option to appeal payment amounts for services. The Lower Health Care Costs Act discussion draft includes multiple options to end out-of-network surprise medical bills, including a benchmark for the amount insurance companies would pay providers, as well as allowing the insurer or provider to initiate an arbitration process for certain surprise bills.

3. During opening remarks at the hearing, Ms. Hassan said: "It is completely unacceptable that people do everything that they're supposed to do to ensure that their care is in their insurance network and then still end up with large, unexpected bills from an out-of-network provider. As has been mentioned, I have been working with Sens. Cassidy, [Lisa] Murkowski, [R-Alaska], and others to address this issue in a bipartisan way."

4. Ms. Hassan also expressed support for independent dispute resolution. She said she supports this approach since providers and health plans haven't been able to agree on a benchmark payment rate.

5. Sean Cavanaugh, former deputy administrator and director of the Center for Medicare at CMS, told the panel: "If you were to go the benchmark route ... You will run into unanticipated consequences, and someone is going to need to figure out how to adjudicate all those situations."

You can watch video of the hearing here.


More articles on healthcare finance: 

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