Coalition Urges Congress to Avoid Jamming Surprise Billing Into Year-End Package

 

Members of the National Taxpayers Union and 14 other taxpayer, consumer, and free-market advocates submitted a letter to Congressional leaders to express concerns about legislation U.S. Senator Lamar Alexander, Republican from Tennessee, is pushing.

As The Tennessee Star reported in July, surprise medical billing happens when a patient receives out-of-network care without his or her knowledge – either in an emergency or during a visit to an in-network facility. Weeks later, insurance companies send bills demanding patients pay money for services they assumed insurance would cover.

Members of Americans for Prosperity, the Center for a Free Economy, FreedomWorks, Institute for Liberty, and the Taxpayers Protection Alliance among others, signed the letter.

The letter asks Congressional leaders to avoid including surprise billing legislation in a larger year-end legislative package.

“Though we may disagree on the best methods to resolve payment disputes over surprise bills, we are unified in believing that this serious issue should be examined and debated on its own merits, not tucked into a large or unrelated bill as some expedient ‘pay-for’ to mask runaway government spending,” the letter stated.

“The surprise billing issue has led to a fierce debate inside and outside Washington. While all stakeholders agree on the need to protect patients from balance billing, there is considerable disagreement over how to resolve inevitable payment disputes between providers and insurers. The topic has captured a significant amount of time and attention of the congressional committees with jurisdiction over health issues, especially the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions. Yet, much more work remains to be done to arrive at a comprehensive and viable solution.”

The issue, the letter went on to say, deserves a standalone vote and an opportunity for focused floor debate, the letter said,

“Jamming a surprise billing proposal into unrelated legislation, such as an appropriations bill that doubles down on the growth of federal spending or a drug pricing bill, is inconsistent with the impact this issue has on the health care system at large,” according to the letter.

As The Tennessee Star reported in July, two Tennessee state representatives, one a Republican, another a Democrat, have called out Alexander for this bill.

In a joint letter, State Rep. Susan Lynn, R-Mount Juliet, and State Rep. John DeBerry, Jr. D-Memphis, called out Alexander for advocating a process known as “benchmarking.”

Lynn and DeBerry referred directly to Alexander’s Lower Health Care Costs Act.

“This approach (“benchmarking”) would permit the federal government to set payment rates for doctors performing out-of-network care across the country. In doing so, benchmarking opens a can of worms that would ultimately threaten health care for millions of people,” the two state representatives wrote.

“This form of government rate-setting would be particularly harmful for hospitals, clinics, and emergency rooms serving Tennessee’s hard-to-reach rural patients as well as underserved urban communities. Allowing the government to dictate provider reimbursement rates—and to set arbitrarily low ones at that—would lead to many doctors being underpaid for the services they provide. America’s hospitals and other health care centers would be forced to contend with billions of dollars in losses.”

Many facilities in Tennessee already struggle to keep their doors open, particularly those serving uninsured, Medicaid, or Medicare patients, the two state representatives wrote.

“This could lead to more hospitals closing down or consolidating, either of which would mean fewer options, increased burdens, higher prices, longer wait times, and a diminished quality of care for Tennessee patients” Lynn and DeBerry wrote.

“There are, however, more workable solutions in Congress that would protect patients from surprise medical billing without jeopardizing health care for anyone. Instead of benchmarking, these proposals call for an Independent Dispute Resolution to shield patients from being caught in the middle of a billing dispute between providers and insurers. IDR establishes a balanced billing negotiation process that encourages transparency and fairness, allowing both parties to submit their best ‘offer’ through an online portal. In 30 days or less, a final payment is determined by an impartial, third-party mediator.”

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected].