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An ER is ready to treat, and bill, the next patient. Photo: Jeff Greenberg/Universal Images Group via Getty Images

Physician outsourcing companies and private equity firms are enlisting new groups to lobby Congress as it considers how to protect patients from receiving large bills from out-of-network doctors who are at in-network facilities.

The big picture: Physician groups who most often mail out surprise medical bills are fighting proposals that take a bite out of their incomes, but ease patients' financial burdens.

Driving the news: An "informal coalition" called US Physician Partners just hired Akin Gump to lobby over surprise bills, the group's third lobbying hire of the year.

  • US Physician Partners is affiliated with 3 physician staffing companies: US Acute Care Solutions, US Anesthesia Partners and US Radiology Specialists. Many surprise bills come from emergency room doctors, anesthesiologists and radiologists.
  • These same organizations funded another group that aired ads with false statements about a congressional proposal to cap doctors' out-of-network charges, PolitiFact and Kaiser Health News reported.
  • Private equity firm Welsh, Carson, Anderson & Stowe has an ownership stake in all of those companies.
  • US Acute Care Solutions did not address the lobbying in a statement, but said it supports legislation that would "incentivize all providers and insurers to negotiate in good faith." None of the other companies or firms immediately responded to questions.

Private equity firms have gravitated toward specialties like emergency medicine and anesthesia because those niches hold enormous market power. Now they and their portfolio companies are ratcheting up their lobbying presence as Congress gets closer to hammering out a final bill.

  • TeamHealth, a physician outsourcing firm that was bought out by private equity giant Blackstone in a $6.1 billion deal in 2016, just hired its first new lobbyist in 3 years amid the surprise billing standoff.
  • Envision, which was taken private by KKR last year in a $10 billion deal and is considered a serial user of surprise billing, has spent almost $500,000 on federal lobbying since the start of 2018.

Go deeper

Study: Fear of debt keeps Latinos out of college

Illustration: Aïda Amer/Axios

Fear of never being able to pay off school loans is keeping many young Latinos in the U.S. from going to college or completing a degree, according to a report published in September.

State of play: Latinos tend to have more difficulty repaying school debt than white student borrowers, according to Federal Reserve data, at the same time that they need more loans in order to afford tuition.

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Scoop: Biden administration objects to Israeli settlements plan

Israeli PM Naftali Bennett (L) meets with Secretary of State Tony Blinken. Photo: Olivier Douliery/Pool/AFP via Getty

The Biden administration has privately protested to the Israeli government over its plan to approve the planning and construction of more than 3,000 new housing units in the Israeli settlements in the occupied West Bank, sources briefed on the issue tell me.

Why it matters: The approvals for new homes in the settlements will be the first since President Biden assumed office, and come after Biden and his top aides personally pressed Israeli Prime Minister Naftali Bennett to restrain settlement activity and decrease the number of new housing units.

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Pentagon warns of ISIS-K capabilities outside Afghanistan

The site of an airstrike conducted by the U.S. against a planner for ISIS-K in Nangarhar province, Afghanistan in August. Photo: Xinhua via Getty Images

U.S. intelligence believes ISIS-K has the "intent" to eventually launch attacks outside of Afghanistan and could be capable of doing so "somewhere between six or 12 months," a top Pentagon official told senators Tuesday.

Why it matters: The U.S. withdrawal and subsequent Taliban takeover of Afghanistan has raised fears that terrorist groups will reconstitute and potentially pose a renewed threat to the U.S. homeland.