Lawmakers hopeful billing legislation emerges from pandemic’s shadow

By | August 7, 2020

Members of Congress are hopeful that stalled efforts to eliminate surprise medical billing practices will start back up with another round of coronavirus economic aid legislation.

“The logical next step is to include in the next round of COVID legislation the market-based solution agreed on by two House committees and our Senate health committee,” Sen. Lamar Alexander said in a statement to the Washington Examiner.

Alexander, a Tennessee Republican who is set to retire this year(his possible replacement, the former ambassador to Japan, Bill Hagerty, won his primary race on August 6), introduced the Lower Health Care Costs Act in 2019, which would shield patients from surprise medical bills and would use a benchmark to resolve payment disputes between insurers and out-of-network providers. The bill stalled in the Senate last summer and has not been revisited, but provisions to eliminate surprise billing practices may be included in the next coronavirus economic stimulus package currently in negotiations. Last week, the Trump administration urged Congress to tackle the issue by passing legislation, but members in the House and Senate have yet to finalize a deal.

“Last week, the White House called on Congress to end surprise medical billing, and Speaker Pelosi said, ‘Let’s get it done,'” Alexander said. “Patients need protection from surprise medical bills in the middle of a pandemic and permanently.”

A GOP aide told the Washington Examiner that bipartisan talks between Democrats and Republicans are continuing and will likely lead to a compromise that could eliminate the practice of surprise billing and make both sides of the aisle happy.

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The Democrats’ Heroes Act, which passed in the House in May with only one Republican supporter, sought to ban surprise billing for patients with COVID-19 and would require healthcare providers to accept payments through the Provider Relief Fund established by the massive CARES Act signed in March. However, the Heroes Act would not eliminate the surprise billing problem for all medical services.

According to the GOP aide, now is the best time to pass a law eliminating surprise billing practices permanently given that unexpected doctor bills can be financially crippling. The coronavirus pandemic has led to economic devastation, inciting mass layoffs and business closures that, coupled with an overwhelming medical bill, could ruin a person’s life.

Outside groups that represent doctor groups, health insurance providers, and patients, such as the Coalition Against Surprise Medical Billing, are encouraged by bipartisan efforts to enact legislation to end the practice permanently.

“The conversations and the new engagement that we’ve seen both from the House and the Senate — and those that have been the strongest and most vocal champions — have gotten even louder,” a spokesperson from the Coalition Against Surprise Medical Billing told the Washington Examiner.

While the coalition is optimistic that Congress will introduce a comprehensive bill that appeals to all sides, members worry about efforts by opposed outside groups such as Doctor Patient Unity and TeamHealth to undermine efforts to create a fix. Those groups have launched multimillion-dollar ad campaigns targeting lawmakers who support efforts to eliminate surprise billing procedures.

Doctor Patient Unity did not respond to requests for comment, and TeamHealth declined an invitation to speak. However, TeamHealth said in a message that Alexander’s bill “is a giveaway to big insurance companies that will lead to a 20 percent pay cut for frontline doctors and healthcare providers in the middle of a worldwide pandemic.”

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The group added that “this legislation was misguided before COVID-19, but it’s downright reckless in the current environment.”

Since legislation targeting surprise billing has stalled, so have wide-reaching ad campaigns undercutting the bills up for consideration. Members of the Coalition Against Surprise Medical Billing said they were relieved to find that members of Congress “have seen through what was just bad messaging and not accurate assessments of the problem.”