Just days after leaders from the House Energy & Commerce Committee released surprise billing legislation details, the House Ways & Means Committee leaders announced a vague outline for their own proposal, calling for lawmakers to delay legislative action until 2020.  

The new proposal from House Ways & Means Chair Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Texas), complicates the legislative landscape for surprise billing legislation as Congress hurtles toward an end-of-year deadline to fund the government. 

"It's really important to get this solution right, both for patients and for providers and insurers to make sure it's balanced, so it's important that Congress not rush into a solution," Kevin Brady said, according to ModernHealthcare. "Chairman Neal and I believe this should be the first issue Congress takes up when we get back after the first of the year."

Patients can face “balance billing,” in which a provider not covered by their insurance plan will charge them the full difference between what the insurer is willing to pay and what the provider wants to charge. Research from Families USA/Perry-Undem poll shows 18% of ER visits and 16% of in-patient hospital admissions result in a surprise bill of some kind, with nearly half of Americans reporting the receiving of a surprise bill. 

"I'm all for Ways and Means being at the table but not at the expense of delaying this until 2020. There's a bipartisan, bicameral, fully drafted and fully scored deal on the table. Congress needs to get this done before we go into an election year," Shawn Gremminger, senior director of federal relations at Families USA, said. 

All major details remain unclear, and the plan appears somewhat different from other legislative proposals that have been offered to Congress in the past. Potential savings from the proposal were not provided in the summary. 

California Hospital Association (CHA) President and CEO Carmela Coyle and California Medical Association (CMA) CEO Dustin Corcoran have issued a joint statement on congressional efforts to address surprise medical billing.

“Over the past few days, two new federal proposals to eliminate surprise billing have emerged from different congressional committees,” the statement reads. “While efforts to address this important issue are welcome, the complexities involved demand thoughtful and thorough debate so lawmakers can fully understand the impact of both proposals, rather than trying to jam legislation through Congress before the end of the year.

As we have experienced in California, benchmark rates become the de facto rate for all doctors and hospitals, including those who are in-network,” Corcoran said. “It gives insurers an excuse to drop contracts with physicians — with the end result being fewer physicians, disruptions in care for patients, and a destabilization of our entire medical care system.

CHA and CMA strongly urge Congress to oppose a benchmark rate as a way of addressing surprise medical billing. Additionally, we call on our lawmakers to give this important issue the time and attention necessary to craft a solution that truly benefits patients, not insurance companies.”

Read the full summary Here.

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