Three key lawmakers have reached a deal on the issue of surprise medical bills, according to two sources familiar with the negotiations.
How it works: The proposal — which has been agreed to by Sen. Lamar Alexander (R-Tenn.) and Reps. Greg Walden (R-Ore.) and Frank Pallone (D-N.J.) — would set benchmark rates for the providers who send such bills, and it would use an arbitration process to settle certain high-value payment disputes.
Sen. Lamar Alexander (R-Tenn.). Photo: Astrid Riecken/Getty Images
The health care industry is not very happy with Congress' latest proposal on surprise medical bills, which also includes other provisions designed to lower health costs.
Driving the news: The bill, championed by Sen. Lamar Alexander and Reps. Frank Pallone and Greg Walden, cracks down on industry behavior that is often profitable at patients' expense.
Jurisdictional infighting and intense lobbying from industry ultimately scuttled Congress' efforts to deal with surprise medical bills this year.
Why it matters: Surprise bills were about as close to a slam-dunk as Congress gets in health policy, and lawmakers' failure to get such an easy thing across the finish line doesn't bode well for other, harder priorities.
Four specialties that are often out-of-network — anesthesiologists, pathologists, radiologists and assistant surgeons — raise employer insurance spending by 3.4%, according to a new study in Health Affairs.
Why it matters: Surprise medical bills are not only unaffordable for the patients who receive them, but also inflate everyone else's premiums.