Providers, Insurers Play Blame Game Over Patients’ Surprise Medical Bills
Physicians groups say the problem is surprise gaps in insurance coverage while insurers counter that more doctors are rejecting in-network rates, then charging out-of-network fees that are many times higher.
The Wall Street Journal:
Surprise Medical Bills Fuel Fight Between Providers, Insurers
The growth of insurance plans built around small networks of health-care providers is fueling new fights over surprise medical bills, when patients inadvertently get care from out-of-network doctors. Providers and insurers are blaming each other for sticking patients with higher bills in such cases, and nearly two dozen states have passed or are considering legislation to protect consumers. (Beck, 7/8)
In other national health care news —
The Washington Post:
Congress Set To Pass Bill To Combat Opioid Abuse
Congress this week is expected to send President Obama legislation to combat heroin and painkiller abuse, despite lingering disputes over whether there is enough funding to support new treatment and prevention programs. Senate Democrats have pushed for additional funding arguing that without it the bill will not be able to deliver on its promise to help thwart the opioid epidemic. But they do not plan to block the agreement that House and Senate negotiators finalized last week, according to a spokesman for Minority Leader Harry Reid (D-Nev.). It’s unclear how many Democrats will support the bill, but it is expected to easily be approved just in time for the height of the election season. (Demirjian, 7/11)
The Wall Street Journal:
Big Insurers Defend $34 Billion Merger
Aetna Inc. and Humana Inc. face resistance from the Justice Department to their proposed $34 billion merger and an uphill battle persuading antitrust enforcers the deal won’t harm competition, according to people familiar with the matter. The insurers on Friday met with top government officials in a late-in-the-game attempt to make their case that the deal has public benefits and won’t hurt consumers, and that they could address competitive concerns through asset sales, people familiar with the matter said. (Kendall and Wilde Mathews, 7/8)
Stat:
Pharma Dollars Went Overwhelmingly To Lawmakers Opposing Medicare Part B Overhaul
After the Obama administration unveiled a proposal to overhaul Medicare Part B four months ago, a large number of lawmakers quickly and very vocally opposed the effort. Now, a new analysis finds that drug makers, who are worried the plan will cut into their revenue, have given them considerably more financial support than lawmakers who have not raised objections. Specifically, 310 lawmakers who either signed two letters opposing the overhaul or were critical of it received a total of more than $7.2 million from pharmaceutical and health products companies for their 2016 campaigns, according to the analysis by Public Citizen, the consumer advocacy group, which released its analysis on Monday. And the amount given to each representative averaged more than $23,300 (read the letters here and here). (Silverman, 7/11)
Politico Pro:
Moon Shot Won't Take Down Drug Costs
Vice President Joe Biden yelled about the unacceptable costs of cancer drugs at his recent moon shot summit, but so far there's no indication drug prices will be anything more than a talking point in the ambitious quest to speed cancer therapies. Instead, the government and private sector partnerships that develop out of the project could just add to tensions over the government's responsibility to control the costs of drugs whose development it helps fund. (Karlin-Smith, 7/8)