Hospital, doctor lobbies support surprise billing protections — but not bundled payments
- Following reports across the country of patients stuck with costly out-of-network bills — even after seeking care at an in-network facility — lawmakers on Capitol Hill called on experts to explain the issues at play and possible solutions during a hearing Tuesday in front of the House Education and Labor health subcommittee.
- Finding a federal solution to the problem did appear to have bipartisan support. "It is so important that we solve this problem. This is a real problem that's affecting people every single day," Van Taylor, R-Texas, said, adding: "I'd rather have something that's going to go all the way to the president's desk than something that's not going to get anything done."
- In a letter sent to lawmakers following the hearing, the lobby groups representing America's doctors and hospitals said they would support consumer protections regarding surprise billing, but they would not support solutions that attempt to bundle payments. "This concept may seem simple and straightforward in theory; in reality however, this approach would be administratively complex, fundamentally change the relationship between hospitals and their physician partners, and alone, does nothing to protect patients from surprise bills," according to the letter from the American Hospital Association, the Federation of American Hospitals and the American Medical Association.
Although some states have worked to craft their own solutions to curb surprise bills, many have found that they're preempted by federal laws. Nearly half of privately-insured Americans are covered by ERISA-regulated plans and attempts to add consumer protections would need to come from Congress.
Some of the solutions discussed Tuesday include capping rates to a percentage of Medicare reimbursements in emergency situations and requiring hospitals to ensure that providers practicing at their facility bill in-network prices.
Taylor urged the chairwoman of the subcommittee, Florida Democrat Frederica Wilson, to work with Republican colleagues to draft a bipartisan solution so it will be considered by the Senate and President.
"Let's get something done on a bipartisan basis," Taylor said to Wilson. "I'm with you and I look forward to working with you on this."
"You got a deal," Wilson replied.
The Government Accountability Office recently released a report that found nearly 70% of air ambulance rides in 2017 were out-of-network, potentially exposing patients to significant bills. It's been a tricky issue to solve, and nearly impossible at the state level given air ambulances are federally regulated just like traditional air carriers, preempting states from regulating prices or routes.