Morning Briefing
Summaries of health policy coverage from major news organizations
Bipartisan Group Of Senators Proposes Using Outside Arbitrator To Settle Disputes Over Surprise Medical Bills
A bipartisan group of senators on Thursday introduced legislation to protect patients from massive, unexpected medical bills, as momentum grows around the issue. The legislation, led by Sens. Bill Cassidy (R-La.), Maggie Hassan (D-N.H.) and Michael Bennet (D-Colo.), comes as the House also introduced legislation this week, and President Trump called for action last week. (Sullivan, 5/16)
The new bill from Sens. Bill Cassidy (R-La.) and Michael Bennet (D-Colo.) has been in the works nearly a year. Under the proposal, a patient's insurer would automatically pay the out-of-network doctor or hospital about the same rate it would pay if the service were in network. But adding arbitration gives industry an appeals process that hospitals and specialty physicians want. (Luthi, 5/16)
The updated version combines two proposals. If the measure is enacted, providers would be prohibited from balance billing patients, or charging them for the remaining cost for treatment that insurance would not cover, and would instead pay the in-network rate and cost-sharing for the treatment, according to a summary. Under the proposal, providers would automatically be paid the difference between the patient鈥檚 in-network cost-sharing and the median in-network rate. Providers and insurance companies could then appeal that payment through arbitration, where both sides would propose their best offer and an independent third party would choose one based on commercially reasonable rates in that geographic area. (McIntire, 5/16)
Sen. Ron Wyden (D-Ore.) on Wednesday proposed a bill requiring insurers to tell people what they would have to pay out of pocket for any in-network treatment or prescription drug. The bill is part of the broader push in Congress and from the Trump administration to force healthcare prices out in the open. (Luthi, 5/16)
A rare point of potential common ground for U.S. President Donald Trump and members of Congress from both parties has emerged on the topic of medical bills. Much of the debate over health care in America -- which unlike most rich nations doesn鈥檛 provide treatment for all citizens -- is what to do about the tens of millions of people who lack coverage. The latest issue to flare involves people who do have coverage, yet still can be financially imperiled by sky-high "surprise billing." (Ruoff and Parnass, 5/17)
