Two Tennessee state representatives, one a Republican, another a Democrat, have called out Tennessee Republican Sen. Lamar Alexander for what they call “a dangerous proposal” in a bill he’s introduced to address surprise medical billing.
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.
In a joint letter released Monday, 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.”
New York implemented IDR in 2015 to protect patients from surprise billing, the two state representatives wrote.
“Since then, in-network rates have increased as out-of-network ones have decreased, all while not impacting the cost or quality of care in emergency room settings,” Lynn and DeBerry wrote.
“This is the model that Congress should seek to replicate.”
Republican U.S. Sen. Marsha Blackburn of Tennessee and U.S. Congressman Phil Roe, a Republican representing Tennessee’s First Congressional District, support IDR, Lynn and DeBerry wrote.
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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected].
[…] Tennessee Star reported in July, surprise medical billing happens when a patient receives out-of-network care without his or her […]
[…] Tennessee Star reported in July, surprise medical billing happens when a patient receives out-of-network care without his or her […]
[…] As 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. […]
[…] The Tennessee Star reported in July, surprise medical billing happens when a patient receives out-of-network care without his or her […]
[…] The Tennessee Star reported, Alexander’s Lower Health Care Costs Act was called out as a “dangerous proposal” by State […]
[…] The Tennessee Star reported last month, surprise medical billing happens when a patient receives out-of-network care without his or her […]
IF YOU THINK THIS LEGISLATION SHOWS LAMAR TRUE COLORS, PLEASE GO BACK AND READ HIS HR5 LEGISLATION ON EDUCATION.
HE IS NOT AND NEVER HAS BEEN A CONSERVATIVE. HOPE YOU WILL READ IS SBHR5. IT IS APALLING TO EDUCATION
Lamar Alexander, you’re showing your true elitist colors. The federal government doesn’t need anymore power over our medical care system. Oh, I forgot. You aren’t one of us “little” people who would be affected by this bill.
Representatives DeBerry and Lynn shouldn’t allow their concern for citizen’s healthcare and the economic viability of rural healthcare providers to get in the way of Senator Lamar Alexander’s longstanding close personal relationship with the insurance industry’s lobby.
That could be harmful to their re-election possibilities when the Senator retires next year.
I am so sick of the race card being pulled in every situation that comes up. ALL LIVES MATTER! PLAIN AND SIMPLE. RED, YELLOW, BLACK OR WHITE. THEY ALL MATTER. DOES THAT MEAN WE HAVE TO OPEN OUR BORDERS AND LET JUST EVERYONE IN? HELL, NO IT does NOT! WE DO NOT HAVE THE RESOURCES TO KEEP UP EVERY PERSON TRYING TO COME INTO OUR COUNTRY. MANY WANT ON WELFARE AND ALL FREE THINGS THEY CAN GET. WE HAVE THE RIGHT TO PICK AND CHOOSE THE ONES. WE THINK WILL BE PRODUCTIVE. GIVE SOMEONE A YEAR AND IF THEY ARE TAKING FROM OUR COUNRT AND NOT BENEFITING OUR NATION, SEND THEM BACK HOME. AND FOR CRYING OUT LOUD SEND THOSE 4 WOMEN THAT ARE A THORN IN PRESIDENT THRUMPS SIDE BACK TO IRAN OR WHEREEVER THEY ARE FROM BECAUSE WE DON’T NEED THEM OR ANYMORE LIKE THEM. PRESIDENT TRUMP BUILD THAT WALL!