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December 11, 2019 07:34 PM

House committee springs new surprise billing proposal, calls for delay

Rachel Cohrs
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    House Ways & Means Committee leaders announced vague outlines of a new proposal to address surprise billing on Wednesday and called for lawmakers to delay legislative action on the issue until 2020.

    The announcement comes just days after leaders of the House Energy & Commerce Committee released details of their own surprise billing legislation.

    The new proposal from House Ways & Means Chair Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Texas) complicates the legislative landscape for surprise billing legislation as Congress hurtles toward an end-of-year deadline to fund the government. Brady told reporters Wednesday that he wants to delay action on surprise billing until next year.

    "It's really important to get this solution right, both for patients and for providers and insurers to make sure it's balanced, so it's important that Congress not rush into a solution," Brady said. "Chairman Neal and I believe this should be the first issue Congress takes up when we get back after the first of the year."

    The Ways & Means outline comes just days after House Energy & Commerce leaders reached a deal with Senate health committee Chair Lamar Alexander (R-Tenn.) on a separate legislative proposal that has the support of the White House. That bill would require plans to pay providers at least the median in-network negotiated rate and includes an arbitration backstop for providers to appeal payments with a threshold of a $750 in-network rate.

    Energy & Commerce Committee Republicans blasted the Ways & Means legislative outline on Wednesday and emphasized their desire to move legislation this year.

    "This is the only bipartisan package that can become law, and we need to act now, this year," an Energy & Commerce GOP spokesperson said.

    Shawn Gremminger, senior director of federal relations at Families USA, said the consumer advocacy group is also eager for movement by the end of the year.

    "I'm all for Ways and Means being at the table. But not at the expense of delaying this until 2020. There's a bipartisan, bicameral, fully drafted and fully scored deal on the table. Congress needs to get this done before we go into an election year," Gremminger said.

    A congressional aide supportive of the Energy & Commerce compromise legislation called the Ways & Means release "ridiculous House jurisdictional jockeying," and said that if action on surprise billing is delayed, decisive action on other issues that could be attached to the Energy & Commerce and Senate health committee legislation, like funding for community health centers, could also be pushed back.

    Providers, however, have been calling to slow down congressional action on surprise medical bills.

    "We're encouraged that the House Ways and Means Committee has joined the deliberations with fresh bipartisan thinking to protect patients from surprise medical bills," said Federation of American Hospitals President and CEO Chip Kahn.

    The Ways & Means plan appears somewhat different from other legislative proposals that have been offered in Congress, but all major details remain unclear. A legislative summary described a "reconciliation process" if providers and insurers cannot agree on payment for emergency or out-of-network care at in-network facilities.

    The process would consider payments made to similar providers for similar services in similar areas, according to the summary. The loser in the reconciliation process would pay a fee, and providers and plans would have to pay a fee if they used the process too often.

    The Ways & Means summary did not provide any details about about potential savings from the proposal.

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