House committees break logjam, setting up ‘showdown’ on surprise billing

Two U.S. House committees have advanced differing legislative proposals to address surprise medical billing, with one more favored by radiologists and other specialties.

Those included a “commonsense” new pitch from the Ways & Means Committee, which uses a baseball-style arbitration process to settle disputes between providers and payers. Lawmakers passed the bill unanimously on Feb. 12, also giving physicians the ability to “batch” together arbitration claims to help improve efficiency and limit burdens, the American College of Radiology reported Feb. 13.

The college commended this version of the legislation in a separate post, prior to its approval, calling it a “thoughtful approach” to addressing this issue.

“We look forward to working with the Ways and Means Committee, and others, in the coming weeks to refine this important policy to ensure the mediator can equally consider multiple data points, while still respecting the private market dynamics between insurance plans and providers, and most importantly, protecting patients,” ACR said in a statement.

Meanwhile, the House Education and Labor Committee advanced its own separate plan on Feb. 11 in a 32-13 vote. This plan would utilize a federal benchmark to settle payment disputes,
ACR noted, with optional arbitration for bills over $750. ACR and other providers have opposed such a system, “as the majority of bills generated by radiologists fall well below the arbitration trigger.”

In its own statement, HELC members said the current “status quo is unacceptable,” with surprising billing an “all-too-common product of our complex health care system.”

“Patients are getting hit with astronomical bills and both payers and providers are facing an uncertain future,” added Rep. Robert Scott, D-Va., chairman of the committee.

Following both passages to clear up this “logjam,” the ACR said this sets up a “showdown” as four congressional panels attempt to sort out all of these differences.

“The White House will undoubtedly play a role in negotiations as well,” ACR noted.

Read more at the American College of Radiology’s News Hub: