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On the Hill: Surprise Billing Legislation, MFAR Working Group

The House Committee on Ways and Means released its long-anticipated legislation to curb surprise medical bills for out-of-network care, the Consumer Protections Against Surprise Medical Bills Act of 2020.

The bipartisan legislation 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.

America’s Essential Hospitals appreciates the bipartisan work by the committee leaders to respect negotiations between hospitals and health insurers and the need to recognize types of providers and services when setting appropriate payment levels.

The Ways and Means Committee will mark up the legislation Feb. 12.

Also, the bipartisan leaders of the House Committee on Education and Labor released that panel’s bipartisan legislation on surprise billing, the Ban Surprise Medical Billing Act, and will mark up the bill Feb. 11.

The legislation would establish a federal benchmark payment to providers for out-of-network care that is based on the median commercial rate for the service in a geographic area, which is similar to the bicameral proposal released late last year from the leaders of the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions. Both legislative proposals would allow providers and plans to pursue an independent dispute resolution process for disputed charges greater than $750.

President’s FY 2021 Budget Proposal

Meanwhile, the president released his budget recommendations for fiscal year (FY) 2021, which outlines the key funding priorities for the administration, including health care.

Health and Human Services Secretary Alex Azar is scheduled to testify on the president’s proposed health care funding for FY 2021 before the Senate Committee on Finance Feb. 13.

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. Please contact Vice President of Legislative Affairs Carlos Jackson at: cjackson@essentialhospitals.org to join the working group.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.

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