American Society of Plastic Surgeons
For Consumers

Congress: House Continues Work on Surprise Billing

Following the two-week congressional recess, two key House Committees – Ways and Means and Education and Labor -- plan to move forward with their own surprise billing legislation in the coming months. However, neither committee has formally announced a date to markup the critical legislation.

Ways and Means Committee Chairman Richard Neal (D-Mass.) sent a letter to his Democratic committee colleagues proposing negotiated rulemaking to "address the [payment] disagreements" related to surprise medical bills, noting that "[t]his process has already been successfully used in the healthcare context." Neal hoped that the use of a committee of stakeholder groups and administrative agencies to determine how to resolve billing disputes between providers and payers would help overcome existing obstacles.

Ranking Member Kevin Brady (R-Texas) has since rejected this proposal, instead suggesting that lawmakers should go "back to the drawing board." Brady has voiced support for a policy similar to the one advanced by the Energy and Commerce Committee, which would use an independent dispute resolution (IDR) process as a backstop in certain circumstances for providers to appeal a benchmark payment rate set by legislation. In response to Rep. Brady's comments, Chairman Neal's office stated that they continue to work in a bipartisan manner to explore all options available to address surprise medical bills.

Meanwhile, members of the Education and Labor Committee also continue their work on surprise billing and will likely use the introduced version of H.R. 3630, the No Surprises Act, as the starting point for their deliberations. H.R. 3630 was reported out of the Energy and Commerce Committee in July but was also referred to the Education and Labor Committee for consideration. While the bill has an IDR process, it is very limited in its scope so the provider community has demanded additional improvements.

However, 20 members of the committee are cosponsors of a competing bill, H.R. 3502, the Protecting People From Surprise Medical Bills Act, introduced by Reps. Raul Ruiz (D-Calif.) and Phil Roe (R-Tenn.). While H.R. 3502 includes a comprehensive IDR process, CBO reportedly stated that the IDR, as proposed in this bill, would cost "double-digit billions". The provider community disagrees with this assessment based on costs associated with New York's IDR implementation. Yet, the cost may complicate inclusion in a final bill.

In the Senate, Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-Tenn.) continues to work with Sen. Bill Cassidy (R-LA) on the inclusion of an IDR process in the HELP-passed product.