Pictured above, from left to right: Molly Smith, vice president of coverage and state issues forum at AHA, Michelle Lindsley, vice president of managed care at Memorial Hermann Health System, and Richard Miller, executive vice president and chief business strategy officer at Northwell Health, speak at AHA’s briefing today on Capitol Hill urging Congress to protect patients from surprise medical bills.

Congress should pass legislation that protects patients from surprise medical bills and rejects rate setting, hospital leaders said today at an AHA briefing on Capitol Hill. 
 
“The thrust of all of this is to protect consumers and hold consumers harmless,” said Richard Miller, executive vice president and chief business strategy officer at Northwell Health in New York. “I think the question becomes what other provisions come along with that that have unintended consequences?”
 
As part of a federal legislative solution, AHA has urged Congress to protect patients from surprise medical bills that they may incur as a result of unexpected gaps in insurance coverage or medical emergencies; allow providers and insurers to negotiate payment rates for services provided after the patient is protected; and reject provisions that are not related to surprise billing, including unworkable price transparency proposals and polices that impede provider and health plan contracting.
 
Michelle Lindsley, vice president of managed care at Memorial Hermann Health System in Houston, expressed concern that some proposals Congress is considering related to rate-setting could put at risk access to services important to patients and the community.
 
While the AHA believes that hospitals and payers should be left to negotiate reimbursement for out-of-network claims without government interference, there may be a role for an alternative dispute resolution process for physician claims, such as arbitration. Miller touted the success of New York’s baseball-style arbitration.
 
Also on the panel were Molly Smith, AHA’s vice president of coverage policy and state issues forum, and Jack Hoadley, research professor emeritus at the McCourt School of Public Policy at Georgetown University.
 

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