New proposal to address surprise medical bills met more favorably by radiologists, hospitals
A new and competing proposal to address patients’ surprise medical bills has drawn positive reactions from radiologists and hospitals alike, after a previous version was widely panned.
The House Ways & Means Committee on Wednesday, Dec. 11, introduced a new policy framework to address unexpected IOUs for medical care, an issue that has drawn ire from lawmakers on both sides of the aisle. This new proposal would, among other things, allow insurers and providers to work out their differences before any government interference in negotiations, according to the summary.
“Patients deserve honest out-of-pocket estimates in advance of scheduled procedures, and there needs to be a fair resolution process for providers and insurers. That is what our proposal achieves,” committee leaders Richard Neal, D-Mass., and Kevin Brady, R-Texas, said in a joint statement. “There are multiple good-faith proposals from other committees, but given our jurisdiction, it is crucial that we get this right.”
A bipartisan group of lawmakers revealed one of those alternate proposals earlier this month, which drew scorn from radiologists and hospitals. More than 900 physicians wrote to House and Senate leaders, concerned that proposed changes would have “devastating unintended consequences” on small and independent practices. And the American College of Radiology urged its members to contact their representatives last week to oppose this version of the legislation, worried that it would place too much power in the hands of insurers.
However, the tone changed following the release of this new version from Neal and Brady.
“We are encouraged by the Ways & Means policy framework and believe it offers a fresh perspective to consider as policy deliberations continue in the New Year,” William Thorwarth, MD, chief executive of the ACR, said in a statement, which was echoed by the Federation of American Hospitals.
The Ways & Means proposal would also preserve state laws that have already addressed surprise medical billing, and add a fee that insurers or providers must pay if they lose in the reconciliation process. Brady is looking to delay action on this issue until next year, where authors of previous versions had hoped to wrap things up by the end of 2019, according to published reports.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.