Commenting on the rate-setting provision of the House Energy and Commerce Committee’s legislative proposal to address surprise medical bills, the AHA, America’s Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States, Children’s Hospital Association, and Federation of American Hospitals said they oppose establishing a benchmark payment to resolve out-of-network payment disputes between providers and insurers and asked that the committee instead consider an independent dispute resolution process.
 
“We are concerned that the rate-setting provision of the [draft No Surprises Act] legislation is a plan-determined, non-transparent process that will upend private payment negotiation,” the groups said yesterday in a joint letter to committee leaders. “A default rate will become the payment ceiling and remove incentives for insurers to develop comprehensive networks, as there are already increasing numbers of narrow network products offered that exclude certain types of providers.”
 
The hospital groups said the committee “should instead consider the establishment of a dispute resolution process, such as arbitration or mediation, as a way to resolve payment issues. Such a process could serve as a backstop after a period of direct negotiation between payers and providers and could, as evidenced by the experience in New York State, both reduce the incidence of out-of-network billing and incentivize network participation.”
 
In February, the groups shared with Congress their principles for evaluating legislative proposals to address surprise medical bills.

Related News Articles

Headline
AHA’s Institute for Diversity and Health Equity March 27 began sending hospitals and health systems an email reminder to complete the 2024 DEI Benchmark Survey…
Headline
AHA March 26 submitted comments on a discussion draft of the SUSTAIN 340B Act, legislation proposed in the Senate to clarify Congress’ intent in creating the…
Headline
President Biden March 24 signed legislation funding the rest of the federal government through Sept. 30, including Department of Health and Human Services…
Headline
The House and Senate Appropriations committees March 20 released the Further Consolidated Appropriations Act of 2024, legislation that would fund all remaining…
Headline
The House Energy and Commerce Committee March 20 unanimously passed AHA-supported legislation to reauthorize through 2029 the Dr. Lorna Breen Health Care…
Headline
The Department of Health and Human Services’ Office for Civil Rights March 18 released updated guidance for HIPAA-covered entities and business associates on…