Where healthcare stakeholders stand on surprise billing

Kelly Gooch - Print  | 

In the fight to stop large, unexpected medical bills when patients are treated by out-of-network providers, physicians, hospitals, insurers and legislators agree: No one wants patients stuck with an outrageous "surprise bill."

But no one seems to agree on how to solve the problem.

Senate Health Committee Chairman Lamar Alexander, R-Tenn., said last week that he and other senators hope to have a bipartisan solution to end surprise medical bills to the Senate floor by July.

Mr. Alexander made the remarks shortly after President Donald Trump's administration said it wants federal legislation to protect patients from surprise medical bills after receiving emergency care from an out-of-network provider when they couldn't pick their caregiver. Federal officials said legislation should also address surprise medical bills that occur after a patient receives care from an out-of-network provider they reasonably thought was in-network.

"We're going to hold insurance companies and hospitals totally accountable," President Trump said at a May 9 White House event, according to The Hill. "We're determined to end surprise billing for American patients. We want patients to be in charge and in total control."

One federal solution is hospital "bundled billing" that aims to ensure patients don't receive separate out-of-network bills. But physician and hospital groups, including the Federation of American Hospitals, American Hospital Association and American Medical Association, have come out against the idea.

They support independent arbitration to settle disputes between insurers and providers by determining whether the amount the physician is charging or the amount the insurer is agreeing to pay is fairer, according to The Hill.

Insurers reportedly don't favor arbitration, though, and want Congress to set reimbursement rates.

Access The Hill's report here.


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