Work on surprise medical bills goes into overdrive

Work on surprise medical bills goes into overdrive
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Lawmakers are moving quickly to try to notch a bipartisan accomplishment and pass legislation protecting patients from massive surprise medical bills, even as they face headwinds from industry and divisions over competing plans.

Days after President TrumpDonald John TrumpUS-Saudi Arabia policy needs a dose of 'realpolitik' Trump talks to Swedish leader about rapper A$AP Rocky, offers to vouch for his bail Matt Gaetz ahead of Mueller hearing: 'We are going to reelect the president' MORE called for action last week, House Energy and Commerce Committee Chairman Frank Pallone Jr.Frank Joseph PalloneHere are the 95 Democrats who voted to support impeachment Overnight Energy: USDA expected to lose two-thirds of research staff in move west | EPA hails Trump's work on reducing air pollution | Agency eyes reducing inspections of nuclear reactors Hillicon Valley: Lawmakers struggle to understand Facebook's Libra project | EU hits Amazon with antitrust probe | New cybersecurity concerns over census | Robocall, election security bills head to House floor | Privacy questions over FaceApp MORE (D-N.J.) and ranking member Greg WaldenGregory (Greg) Paul WaldenOvernight Energy: EPA expands use of pesticide it considers 'highly toxic' to bees | House passes defense bill with measure targeting 'forever chemicals' | Five things to watch as Barry barrels through the Gulf House passes bill to crack down on toxic 'forever chemicals' Overnight Defense: Woman accusing general of sexual assault willing to testify | Joint Chiefs pick warns against early Afghan withdrawal | Tensions rise after Iran tries to block British tanker MORE (R-Ore.) on Tuesday released a draft bill to tackle the problem, a sign of momentum on the issue.

A bipartisan group of lawmakers in the upper chamber, led by Sens. Bill CassidyWilliam (Bill) Morgan CassidyFinding a path forward to end surprise medical billing Liberal think tank: GOP paid parental leave proposals are too narrow Senate GOP raises concerns about White House stopgap plan to avoid shutdown MORE (R-La.), Maggie HassanMargaret (Maggie) HassanFinding a path forward to end surprise medical billing Trump's new labor chief alarms Democrats, unions Second ex-Senate staffer charged in aiding doxxing of GOP senators MORE (D-N.H.) and Michael BennetMichael Farrand BennetDemocratic strategist predicts most 2020 candidates will drop out in late fall The Hill's 12:30 Report: Trump hits media over 'send her back' coverage The Hill's Campaign Report: Second debate lineups set up high-profile clash MORE (D-Colo.), plan to release their own legislation this week.

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And Senate Health Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderFinding a path forward to end surprise medical billing The Hill's Morning Report - Presented by JUUL Labs - Trump attack on progressive Dems draws sharp rebuke Republicans make U-turn on health care MORE (R-Tenn.), along with Sen. Patty MurrayPatricia (Patty) Lynn MurrayFinding a path forward to end surprise medical billing Trump's new labor chief alarms Democrats, unions Overnight Health Care — Presented by PCMA — Sanders mounts staunch defense of 'Medicare for All' | Biden, Sanders fight over health care heats up | House votes to repeal ObamaCare 'Cadillac Tax' | Dems want details on fetal tissue research ban MORE (D-Wash.), are working on their own measure as part of a broader package to lower health care costs.

The goal is to put an end to viral stories like that of a teacher in Texas last year who received a $108,951 bill from the hospital after his heart attack. Even though the teacher had insurance, the hospital was not in his insurance network.

The effort received a boost after President Trump last week lent his voice to it, urging lawmakers to take action.

Trump said the practice of sticking patients with surprise medical bills “must end.”

“We’re going to hold insurance companies and hospitals totally accountable,” Trump said at a White House event.

And administration officials offered lawmakers a set of guiding principles, letting Congress take the lead on drafting a response.

Trump officials have prioritized making sure that patients have the same out-of-pocket costs in-network or outside and that patients are better informed about potentially unexpected payments.

The flurry of activity on Capitol Hill highlights how lawmakers believe stopping surprise medical bills is a rare area where something bipartisan could be signed into law this year, but there are still strong divisions.

Powerful health care industry groups are already knocking the plans they don’t like and pushing for others, trying to protect themselves from taking a financial hit in the legislation.

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“We are open to feedback and discussion,” Walden told reporters on Tuesday. “We just want to get this done and get results because too many people are getting whacked.”

Lawmakers and industry groups all agree in theory that patients should be protected from getting surprise bills when they go to the emergency room and one or more of the doctors treating them are outside their insurance network.

But the question of deciding how much the insurer will pay the medical provider for that care once the patient is out of the picture is proving to be a stumbling block. Doctors, hospitals and insurers are all fighting over the answer.

The House bill released this week essentially sets the rate that insurers would pay doctors, something that medical provider groups are fighting against.

The American Hospital Association hit back at the House bill, saying it would “impose arbitrary rates on providers.”

Doctors’ groups are instead pushing for an outside arbiter to set the payment amount.

The Senate group that includes Cassidy is planning to use this arbitration approach in the bill it is about to release, Cassidy said.

But that approach might not match up with what the other Senate group is working on.

Alexander and Murray could use a different approach in the bill they hope to unveil next month. That will be a key decision, given that Alexander is the chairman of the Health Committee and controls the package that is expected to be moving to the Senate floor.  

“It is close conversations, it’s very amiable,” Cassidy said of Alexander and Murray’s work.

“I can’t tell you exactly where they’re going to land,” he continued, “but I do think there will be an effort to reconcile what the two groups do.”

The White House has also been getting involved in the discussions. Administration officials told reporters last week that they favor an approach other than having an arbitrator set prices.

“They’re active; they’re not being passive,” Cassidy said of the White House.

Walden said the eventual measure, while protecting patients, also should not drive up health care spending.

“I can make everybody in the provider world happy if I just hit the right payment number, but that’s not what this is about either,” he said.