Congress must follow Connecticut’s lead on medical fair billing reform
Exorbitant medical bills have become a painful reality for millions of individuals and families nationwide. While Americans grapple with the high costs of health care, the critical question remains: what can be done to lower these costs while still providing patients with high-quality medical care?
Assessment of this complex question leads us quickly to the realization that there is not one simple solution.
Our elected representatives must take an expansive approach and examine all known cost drivers in order to deliver quality health care in a more affordable way.
A little-known factor that has been contributing to the high cost of care are “facility fees.” As big hospitals and health systems have been purchasing more independent physician practices, they’re charging what are known as facility fees based on care provided in a hospital-based facility. These fees for delivery of care at the new location, often unknown to patients until they receive their bill, are much higher than prices before the acquisition of private doctor’s practices and labs.
Having served as ranking member of the Public Health Committee in the Connecticut House of Representatives, I understand the urgent and ongoing need for meaningful policies that improve our health care systems and deliver the best patient care. I’m encouraged that Connecticut is already a leader in championing medical billing and patient rights. Our leaders recognized an opportunity to bring down these high costs, working in a bipartisan fashion to enact legislation to ensure that patients, providers, hospitals and health care systems were all part of the solution. I’m proud to have supported measures to limit the facility fees passed on to patients for routine evaluations, assessments and care management as well as prohibiting facility fee collection for hospital telehealth visits.
But there’s more work that must be done on the federal level. Fortunately, the Facilitating Accountability in Reimbursements Act is a federal legislative proposal that can accomplish this goal. The FAIR Act offers fair billing reforms that will clamp down on the lack of transparency in hospital billing. This critical legislation is a promising first step to reshaping the landscape of health care billing across the country, safeguarding patients from the unfair financial burden of high medical bills and ensuring that the cost of services does not change due to a medical facility’s ownership or location.
Unfair billing also significantly burdens the Medicare program, and the FAIR
Act could pave the way for future legislation that would result in significant program and beneficiary savings through site-neutral payment reform. This next step would ensure that Medicare pays the same price for medical services delivered in a doctor’s office, regardless of hospital ownership, bringing savings to taxpayers and beneficiaries alike. Implementing fair billing reforms like site-neutral payments could help reduce Medicare spending by $153 billion and reduce costs for Medicare beneficiaries by $94 billion. Ultimately, everyone benefits. Government spending gets relief and people in every community get help.
We need the support of all of our federal legislators to get this across the finish line. Our U.S. senators, Chris Murphy and Richard Blumenthal; U.S. Rep. John Larson; who sits on the House Ways and Means Committee; and others in the Connecticut delegation can help move the needle on this issue. The FAIR Act will help prevent facility fees from adding billions to our health care costs. It’s time for Congress to step in and follow Connecticut’s lead on fair billing reform.