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
The House July 3 voted 218-214 to pass the final version of the One Big Beautiful Bill Act (H.R. 1), which enacts many of President Trump’s legislative…
Headline
The American Society for Health Care Engineering July 1 announced 87 health care facilities as winners of the 2025 Energy to Care Sustainability Champions…
Headline
The U.S. District Court for the Middle District of Tennessee June 30 denied a motion for a preliminary injunction by AbbVie in its lawsuit against the state’s…
Headline
The Senate narrowly passed the One Big Beautiful Bill Act (H.R. 1) on July 1 by a 50-50 tally, with Vice President J.D. Vance casting the tie-breaking vote.…
Headline
The AHA June 29 sent a letter to senators urging them to amend the budget reconciliation bill before its final passage in the Senate. The Senate version of the…
Headline
The AHA June 16 released a fact sheet with analysis on the impact to rural patients and hospitals from proposed Medicaid cuts by Congress. The analysis found…