Key House, Senate Leaders Cut Surprise Medical Billing Deal (1)

Dec. 8, 2019, 7:45 PMUpdated: Dec. 9, 2019, 2:14 AM

Leaders of the House and Senate health committees announced Sunday they have reached a deal on a package of health care legislation including measures to tackle surprise medical billing.

Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health, Education, Labor, and Pensions Committee, and Reps. Frank Pallone, Jr. (D-N.J.) and Greg Walden (R-Ore.), the Democratic and Republican heads of the House Energy and Commerce Committee, said in a statement they’d reach agreement on legislation to end surprise bills, raise the age to buy tobacco products to 21, and extend funding for federal health programs like community health centers.

“I do not think it is possible to write a bill that has broader agreement than this among Senate and House Democrats and Republicans on Americans’ number one financial concern: what they pay out of their own pockets for health care,” Alexander said in a statement.

The legislation could pass as part of a spending bill later this month, Walden said earlier in the week.

Details Still Unclear

The agreement is a change from the surprise billing legislation approved by both the House Energy and Commerce (H.R. 2328) and Senate HELP committees (S. 1895) earlier this year. However, details of the changes are unclear. “It would end surprise billing of patients and include a new system for independent dispute resolution often called arbitration,” the announcement said.

Both committees approved legislation but saw the bills stalled by debate over disagreements in each chamber about how to settle disputes between insurers and providers.

There’s broad agreement on ending what’s known as balance billing, where providers bill patients directly for charges insurers won’t cover. Both committees approved bills that largely force providers to accept a set rate but some lawmakers want doctors to be able seek higher fees via an arbitration process.

Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.), leaders of a group of senators who favor arbitration, said in a statement Sunday they were “encouraged” by the new agreement.

Hospitals Remain Wary

The change didn’t win over the nation’s largest hospital lobby, the American Hospital Association, which has pushed back on surprise billing proposals this year.

“Unfortunately, unless this proposal is much improved over previous bills that rely on a benchmark rate, it remains highly problematic and would jeopardize patient access to hospital care, particularly in rural communities,” Rick Pollack, president and chief executive officer of the trade group, said in a statement.

Hospitals and provider specialty groups have complained that forcing them to accept a typical rate for their services gives too much power to insurers, which negotiate those rates, and their provider networks.

The new agreement, however, doesn’t have the support of a key Senate Democrat: Sen. Patty Murray (D-Wash.), the ranking member on the Senate HELP Committee and an original cosponsor of an earlier surprise billing package, is seeking changes.

“Senator Murray believes the overall agreement takes important steps forward on a number of issues impacting patients and families, and is working with some members of her caucus on concerns they still have,” Helen Hare, a spokeswoman for Murray, said in an email. “She didn’t want to sign onto a press release until those were worked through.”

(Adds comments from hospital industry group starting in the ninth paragraph.)

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bgov.com

To contact the editors responsible for this story: Heather Rothman at hrothman@bgov.com; Fawn Johnson at fjohnson@bloomberglaw.com; Paul Hendrie at phendrie@bgov.com

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