Outlook for surprise billing legislation coming into focus

THE SPRING LANDSCAPE on surprise medical billing action in Congress is taking shape, as all three House committees with responsibility for the issue have advanced legislation.

Two House panels and the Senate health committee have coalesced around an approach that would blend a benchmark payment for certain emergency services at out-of-network facilities or for out-of-network providers at in-network facilities with a limited arbitration backstop. The House Ways & Means Committee put forth an arbitration-only approach. Each has bipartisan support, as the issue does not divide lawmakers along traditional party lines.

Still, even if House lawmakers can reach an agreement, Senate Majority Leader Mitch McConnell (R-Ky.) would have to advance a solution and has not committed to doing so. President Donald Trump is imploring lawmakers to act, tweeting Feb. 12, “Ending surprise medical billing moving ahead in Congress! Thanks to Ways & Means and Education/ Labor Committees for your work on Bills to protect patients and end medical bill ripoffs! Work with Energy & Commerce, HELP committees to send BIPARTISAN bill to my desk!”

Lawmakers are working toward a May 22 deadline, hoping to attach language to a funding bill for some expiring Medicare and Medicaid programs.

Providers and hospitals have rallied around the arbitration-only approach, while insurers, employers and labor unions want some form of benchmark payment. Here’s a breakdown of the leading legislative proposals. ●