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On Wednesday, June 26, the Senate Health Education and Labor (HELP) Committee passed legislation that included ASA-opposed provisions addressing surprise medical bills. S. 1895, the Lower Health Care Costs Act, includes rate setting provisions that benchmark payments to out of network physicians and other providers to median in-network rates, an unworkable provision for physicians that threatens to fundamentally disrupt health care delivery. ASA will continue to oppose this “rate setting” approach. During the hearing, Chairman Lamar Alexander (R-LA) agreed to continue to work with Senator Bill Cassidy (R-LA), an advocate for an arbitration model, on efforts to improve the legislation as the bill advances.
ASA has been actively engaged with the Chairman and the Senate HELP Committee on this legislation. ASA physician leaders and lobbying team have met numerous times with HELP Committee members and staff. Over the last week, more than 4,000 messages have been sent to Senators by ASA members expressing concern about the surprise medical bill provision in the legislation, and more than a dozen state component presidents submitted formal comments or reached out directly to their Senators. ASA also submitted formal comments to the Committee expressing concern with the provisions.
Offsetting the news of the onerous Senate HELP proposal and action, Congressman Raul Ruiz, M.D., (D-CA) and Congressman Phil Roe, M.D., (R-TN) introduced the Protecting People from Surprise Medical Bills Act. This ASA-endorsed proposal is cosponsored by a bipartisan group of 32 members. The Protecting People from Surprise Medical Bills Act is based on the successful model in New York which protects patients and has worked effectively to balance the interests of physicians and insurance companies. The legislation includes a payment of a “commercially reasonable rate” to the physician or other providers and the creation of an independent dispute resolution system. This approach is consistent with the New York state model that has been in place since 2015 and has reduced complaints related to surprise bills while also saving health care dollars.
A recent study found that more than 90 percent of claims filed by physician anesthesiologists are in-network and do not involve unanticipated bills from out-of-network providers, however, ASA believes additional work is necessary to address those small number of cases where patients receive surprise bills.
ASA is encouraging all members to contact their representatives asking them to become cosponsors of the Ruiz-Roe Protecting People from Surprise Medical Bills Act.
Current co-sponsors of the Protecting People from Surprise Medical Bills Act as of 9/10/19:
