As lobbyists purporting to represent doctors and hospitals fight attempts to control surprise medical bills, it has become increasingly clear that the force behind the effort is not just medical professionals, but also investors from private equity firms.
Patients are often told to be smart consumers and shop around for health care before they use it. What happens when people actually take that advice?
A case of questionable logic.
A House committee approved its version of legislation to solve the problem of surprise medical bills. But the measure includes a key provision that’s got less support in the Senate.
The measure also includes a range of provisions designed to address health care costs.
On average, 16% of inpatient stays and 18% of emergency visits left a patient with at least one out-of-network charge, most of those came from doctors offering treatment at the hospital, according to a study by the Kaiser Family Foundation.
A legislative package from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) would handle surprise medical bills by having insurers pay them the “median in-network rate,” meaning the rate would be similar to what the plan charges other doctors in the area for the same procedure.
The Senate Health, Education, Labor and Pensions Committee is scheduled next week to mark up a massive legislative package on curbing health costs, but some of the details remain unresolved, including what formula to use to pay doctors and hospitals involved in surprise medical bills.
The median cost of an air ambulance bill is more than $36,000 and seldom covered by insurance, sparking many consumer complaints. Yet none of the proposals introduced or circulating in Congress to fix surprise medical bills address these services.
The Republican’s legislation, prepared with Sen. Patty Murray, the ranking Democrat on Alexander’s health committee, would be an ambitious lift because it also deals with prescription drug patents, health transparency and vaccine messaging.