Viewpoint: Median pricing model is fairest way to resolve surprise-billing disputes

In an opinion piece for The Tennessean, healthcare consultant Patsy Writesman argues in support of federal surprise-billing provisions that are part of proposed legislation to lower healthcare costs. 

The Lower Health Care Costs Act, introduced 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 that insurers have negotiated with other providers and agreed to in that local area. 

Ms. Writesman, who owns ManageHealthCareCosts.com, praised this approach.

"Alexander is correct to oppose both a government-set rate and the arbitration model," she wrote.

"The median pricing model is the correct solution for a truly economically fair market rate that protects patients and ensures equitable payment to providers without government overreach or lengthy and expensive attorney-driven arbitration," she said.

Read her full column here.

 

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