Feb 13, 2020 - Health

How doctors have shaped the fight around surprise medical bills

Doctors' extensive lobbying on surprise medical bills is partly to blame for Congress' inaction on the issue, reports Kaiser Health News.

Why it matters: "As Congress begins its 2020 legislative session, there is evidence the doctors' message has been received: The bills with the most momentum are making more and more concessions to physicians."

The big picture: Many of the doctors involved in the surprise billing fight are employed by private equity-backed companies.

  • Doctors' voices have a distinct power compared to other industry lobbyists, as they're the ones providing care to patients.
  • Their message to lawmakers, one doctor told Rachana, is that "we just want to be paid a fair amount for the services rendered."

Reality check: Study after study has shown that the doctors that tend to send the most surprise bills also get paid more than other specialties.

  • One study found that four specialties that are often out-of-network raise employer insurance spending by 3.4%.
  • These other specialties — the ones that don't tend to be paid private insurance rates multiple times the amount that Medicare pays — somehow manage to get by.
  • And the relationship to high payment rates and surprise billing isn't random. Researchers say that the potential of surprise bills gives doctors greater negotiating leverage against insurers. One major physician staffing firm admitted as much to lawmakers last year.

Go deeper: Congress remains gridlocked on surprise medical bills

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White House seems to back insurers in fight over surprise bills

Photo: Brendan Smialowski/AFP via Getty Images

In the debate over surprise medical bills, the White House said today it's "concerned that a push to overuse arbitration will raise healthcare costs" — indicating that it's not on board with the approach doctors and hospitals prefer.

The big picture: Congress is gridlocked between two approaches, pitting insurers against providers. White House spokesman Judd Deere also said the administration believes surprise bills from air ambulances should be addressed in the same legislation.

Go deeper: Surprise medical bills inflate everyone's health insurance premiums

Senate Republicans are divided on drug costs and surprise medical bills

Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Senate Majority Leader Mitch McConnell told reporters Tuesday that Senate Republicans are divided on bipartisan bills to address both drug costs and surprise bills, The Hill reports.

The big picture: The White House vocally supports the bipartisan drug pricing bill by Sens. Chuck Grassley and Ron Wyden.

Elective surgery's surprise medical bill risk

Illustration: Lazaro Gamio/Axios

Even patients who plan elective surgeries with in-network doctors at in-network facilities have a pretty good chance of receiving a surprise medical bill, according to a new JAMA study.

Why it matters: Surprise bills are a problem for the patients who receive them, but also for the system as a whole, as they drive up overall health care costs.

Go deeperArrowFeb 12, 2020 - Health