February 12, 2020
Key Committees Consider Surprise Medical Bills Legislation, ASA Focused on Opposition to Rate-Setting
This week, two key House Committees are considering legislation to address surprise medical bills legislation. The House Education and Labor Committee voted to advance legislation that ASA opposes due to its pro-insurer orientation, while ASA encourages further refinement of an encouraging framework from the House Ways and Means Committee.
On Tuesday, the House Education and Labor advanced H.R. 5800, the Ban Surprise Billing Act. This legislation includes several concerning provisions, including an inaccessible independent dispute resolution process and reliance on rate-setting. ASA has significant concerns about the impact of the legislation on physician practices and thus opposes the proposal. ASA believes the approach outlined in the legislation will weaken physician practices across the country with massive payment cuts, while also penalizing physicians who are actually “in-network.” Currently, more than 90 percent of physician anesthesiologists’ claims are in-network. ASA applauds several lawmakers on the Committee who proposed amendment to improve the legislation, but ultimately their efforts were unsuccessful. The bill was reported out of Committee by a vote of 32 to 13.
On Wednesday, the House Ways and Means Committee considered H.R. 5826, the Consumer Protections Against Surprise Medical Bills Act. ASA applauds the Ways and Means Committee for its continued efforts to protect patients from surprise medical bills and is encouraged by the legislative framework as an improvement over other House Committees’ work product. ASA remains concerned that the use of median in-network rate as a specific criterion in dispute resolution will result in the arbiter defaulting to it as a mandated benchmark, resulting in unfair payments for physicians. As negotiations begin to meld the three committee work products into one, ASA will continue to work with Congress to ensure it includes a fair playing field for physicians, including eliminating the reference to median in-network rates.
Over the last week, thousands of ASA members were engaged on these efforts, contacting their lawmakers to express concerns. As these pieces of legislation advance, all ASA members are encouraged to be prepared to continue their grassroots outreach to federal lawmakers.