The act, which was introduced June 19 by Senate health committee Chairman Lamar Alexander, R-Tenn., and health committee ranking member Sen. Patty Murray, D-Wash., addresses surprise medical bills as well as healthcare cost transparency and drug prices.
To settle out-of-network surprise-billing disputes, the legislation requires health plans to pay providers the local median contracted commercial amount insurers have negotiated and agreed upon with other providers.
But Sal Nuzzo, vice president of policy for The James Madison Institute, a Tallahassee, Fla.-based right-wing advocacy group and member of the State Policy Network, wrote in the opinion piece the proposed legislation “would actually hurt patients, by starting a chain reaction that would put their doctors out of business.”
He said the proposal would also negatively affect financial success at private physician practices.
“The bipartisan bill would impose price controls on doctors, compelling physicians to base their rates on those of Medicare and to offer these rates even if patients’ insurers won’t fully reimburse the doctors. This provision would knee-cap physicians who are serving local communities as they attempt to run profitable private practices,” wrote Mr. Nuzzo.
“Worse, the bill would empower health insurers to lower the fixed price of care without passing savings on to patients. Insurers could continue to raise premiums on patients, even while reimbursing doctors less and less,” he added.
Mr. Nuzzo advocated for arbitration as a possibility to resolve out-of-network payment disputes between insurance companies and physicians once the patient is protected. He also advocated for giving states more flexibility with alternatives to ACA mandates.
Read Mr. Nuzzo’s full opinion piece here.
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