Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Politics & Policy
June 18, 2019 01:57 PM

Alexander supports in-network guarantee to end surprise medical bills

Susannah Luthi
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Getty Images
    Sen. Lamar Alexander (R-Tenn.)

    The chair of the Senate health committee showed his support for the so-called "network matching" policy to end surprise medical bills, a proposal sharply opposed by specialty physician groups and the hospitals that employ them.

    In a committee hearing on Tuesday, Sen. Lamar Alexander (R-Tenn.) said the policy, under which hospitals would have to guarantee to their patients that any doctor they see is in-network, is the one he "instinctively liked the best."

    "It seemed to me, if the problem was out-of-network doctors, the solution would be to have in-network doctors," Alexander said. "That seemed to me the simplest solution to the problem. It also saves the most money."

    After the hearing, Alexander declined to confirm whether it's the option that will end up in the final draft of the 165-page draft legislation, even as he announced that the committee will vote on the package next week.

    "We'll see," he told reporters.

    The debate over how Congress should end surprise bills is especially contentious in the Senate health committee, where two members have led a rival effort to pass a more provider-friendly arbitration model backed by specialty physician groups.

    Sens. Bill Cassidy (R-La.), a physician, and Maggie Hassan (D-N.H.) both defended their own proposal, which triggers an arbitration process if out-of-network doctors or any other party aren't happy settling on a median in-network payment rate.

    The health committee also included an arbitration policy, but its stricter limits haven't appeased specialty physicians who have been fighting hard for alternative proposals. Dr. Anthony Cirillo, who is lobbying on the issue for the specialty physician practice US Acute Care Solutions, characterized the panel's model as "sham arbitration" in a media call ahead of the hearing.

    Cirillo and other specialty physician groups are pushing for the Cassidy bill in the Senate and a separate proposal from Reps. Raul Ruiz (D-Calif.) and Phil Roe (R-Tenn.), both physicians, in the House.

    In addition to arbitration, the Senate health committee has also offered a payment benchmark model similar to the measure debated last week in the House Energy and Commerce Committee, which hospitals and specialty physician groups oppose.

    On Tuesday, the American Hospital Association Executive Vice President Tom Nickels argued that a benchmark amounted to rate-setting and would ultimately resemble a single-payer system like Medicare for All.

    But few Republicans appeared to buy that argument, including Sen. Mitt Romney of Utah, who said that "at first blush" he was concerned about the complexity of arbitration, adding that he believed a benchmark based on Medicare rates would be a simpler solution.

    Sen. Mike Braun (R-Ind.) was also skeptical of Nickels' argument and said the industry needed to "wake up" or "Medicare for All will be the only alternative."

    Senators spent less time on a provision that many insurers don't like, which would establish an all-payer claims database nationwide, although witnesses talked about how employers and states have been able to save millions of dollars once they knew how to get a handle on costs.

    Sen. Tina Smith (D-Minn.) brought up the database in order to clarify that the final draft provision would let states maintain their own databases and also get access to the federal claims data, which would include employer-sponsored plan claims, when they need it.

    The senators didn't discuss the bill's proposed contract reforms, bans on all-or-nothing clauses, or anti-tiering and anti-steering agreements, which hospitals hotly contest.

    Sean Cavanaugh, chief administrative officer for the accountable care organization Aledade, said those contract reform provisions would have the most impact on out-of-pocket costs.

    "If I had to quantify the magnitude, the ones that are specifically labeled pro-competition about particular hospital negotiating tactics, I think those will have the most direct and immediate," Cavanaugh said during the hearing.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    rural-health2_i.png
    Kentucky governor signs bill to bolster rural hospitals
    california walgreens abortion pill
    Why Walgreens' decision to restrict abortion pill could affect its growth strategy
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing