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Senate committee approves healthcare package with surprise billing provisions

The Senate Committee on Health, Education, Labor and Pensions this week approved the Lower Health Care Costs Act (S.1895), a broad bipartisan package that aims to reduce healthcare costs. The legislation would, among other provisions, shield patients from surprise medical bills, while using a benchmark rate to settle payment disputes between health plans and out-of-network providers. HANYS strongly opposes setting a benchmark rate, and issued a call to action for members earlier this week.

Notably, during the markup, several senators took issue with the rate-setting approach, expressing a preference for an arbitration method included in other proposals to end surprise bills like the STOP Surprise Medical Bills Act introduced by Sen. Bill Cassidy (R-LA). Along with Sen. Cassidy and others, Sen. Mitt Romney (R-UT) voiced concerns that the benchmark process would “change the dynamic in the negotiating relationship between the insurance companies and the providers. It seems a very one-sided power grab by the insurance industry,” he said.

Senate HELP Committee Chair Lamar Alexander (R-TN) said he hopes the legislative package will make it to the Senate floor for a vote during the third or fourth week of July, also noting that he intends to work with Sen. Cassidy and others to revise surprise billing provisions.

Meanwhile, Rep. Joe Morelle (R-Irondequoit) along with representatives Raul Ruiz, MD (D-CA), Phil Roe, MD (R-TN), Van Taylor (R-TX), Ami Bera, MD (D-CA), Larry Bucshon, MD (R-IN), Donna Shalala (D-FL) and Brad Wenstrup, DPM (R-OH) introduced the bipartisan Protecting People from Surprise Medical Bills Act, which is based on New York’s 2015 Out of Network Consumer Protection Act and outlines an independent dispute resolution process, rather than a benchmark rate like the HELP and Energy and Commerce proposals. More action on surprised billing is expected after the July 4 recess. Contact: Cristina Batt

Published June 28, 2019