The AHA and other national organizations representing the nation’s hospitals and health systems today urged congressional leaders not to include in the next COVID-19 relief package any surprise medical billing legislation that could further destabilize hospitals’ finances as they work to recover from an unprecedented public health emergency.
“Legislative proposals that would dictate a set payment rate for unanticipated out-of-network care are neither market-based nor equitable, and do not account for the myriad inputs that factor into payment negotiations between insurers and providers,” the organizations wrote. “These proposals will only incentivize insurers to further narrow their provider networks and would also result in a massive financial windfall for insurers. As such, we oppose the setting of a payment rate in statute and are particularly concerned by proposals that would undermine hospitals and front-line caregivers during the COVID-19 pandemic. We urge Congress instead to enact a proposal that would completely remove the patient from the middle of payment disputes between insurers and providers, while also preventing the federal rate setting approach that tilts the scales in favor of insurers.”