Physician staffing groups that generate large amounts of surprise medical bills are behind Doctor Patient Unity, the dark-money group running $28 million in ads against Congress' effort to crack down on surprise bills, the New York Times reports.

The two staffing groups, TeamHealth and Envision Healthcare, supply emergency room doctors, radiologists and anesthesiologists to hospitals — specialties that are among the most likely to be out-of-network for patients. Both groups are backed by private equity.

Between the lines: Envision and TeamHealth have a lot to lose from a ban on surprise billing, as it's a lucrative practice for them.

  • The kinds of physicians they employ have a steady patient supply regardless of whether they're in those patients' insurance network. That creates the opportunity for them to charge sky-high rates and then bill patients for what their insurer won't cover.
  • The threat of going out-of-network also gives these providers leverage in their negotiations with insurers, causing in-network rates — and thus premiums — to rise.
  • Congress' leading solution to surprise billing would likely decrease this leverage and thus lead to lower in-network rates for these doctors.

My thought bubble: The choice before lawmakers now could not be more Washington-in-2019: Side with voters getting slammed by these bills, or side with the private equity-backed groups profiting from them.

Go deeper: We all pay for surprise emergency room bills

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