The House committees on Ways and Means and Education and Labor have considered and passed separate proposals to curb surprise medical bills for out-of-network care.
The House Committee on Ways and Means bill, H.R. 5826, the Consumer Protections Against Surprise Medical Bills Act, preserves the ability of providers and health plans to negotiate the payment rate for out-of-network care. If the parties cannot reach an agreement within 30 days, one party can initiate an independent dispute resolution (IDR) process overseen by a mediator, who will determine the level of payment.
The House Committee on Education and Labor’s Ban Surprise Medical Billing Act would establish a federal benchmark payment to providers for out-of-network care charges of more than $750, based on the median commercial rate for the service in the geographic area.
The Congressional Budget Office (CBO) released cost estimates for both pieces of legislation. The CBO reported that the Ways and Means bill would generate close to $18 billion in savings to the federal budget over 10 years, and the Education and Labor legislation would save nearly $24 billion over 10 years.
House committee leadership will seek to reconcile the policy differences among various surprise billing proposals before advancing legislation to the House floor for a vote.
Senate Hearing on President’s Proposed Budget
Meanwhile, Health and Human Services Secretary Alex Azar testified on the president’s proposed health care budget for fiscal year (FY) 2021 last week before the Senate Committee on Finance.
The Secretary defended the budget’s proposals to cut nearly $1 trillion from Medicaid over 10 years and enforce mandatory work requirements, among other policies. Notably, the secretary assured the committee that the administration would continue to work with states on the proposed Medicaid Fiscal Accountability Regulation released by the Centers for Medicare & Medicaid Services (CMS) last November. He also said Medicaid funding would continue to grow under the proposed FY 2021 budget.
America’s Essential Hospitals MFAR Working Group
America’s Essential Hospitals is inviting member hospital government relations and other interested staff to participate in the next phase of its Medicaid Fiscal Accountability Rule (MFAR) advocacy working group. Now that the public comment period on the proposed rule has closed, the association plans to convene the working group regularly to provide updates on the association’s advocacy engagements with members of Congress. The next working group call is scheduled for Wednesday, Feb. 19, at 1 pm ET.
Contact Vice President of Legislative Affairs Carlos Jackson at: email@example.com to join the working group.