The Texas Medical Association is urging Texas lawmakers in Washington, D.C., to show their support for federal legislation on surprise medical bills that includes commercially reasonable upfront payments and independent arbitration.
TMA President David C. Fleeger, MD, on Tuesday urged Texas U.S. representatives to sign a letter to House Speaker Nancy Pelosi (D-Calif.) and House Minority Leader Kevin McCarthy (R-Calif.) to attach the Protecting People from Surprise Medical Bills Act to a federal spending bill before the end of the year. The deadline for lawmakers to sign the letter is Monday, Dec. 9.
Congress this year has been considering several competing measures that would take the patient out of the middle of haggling between physicians and insurers over out-of-network bills.
One version making its way through Congress – HR 3630, the No Surprises Act by Reps. Frank Pallone (D-N.J.) and Greg Walden (R-Ore.) – includes independent arbitration for bills with a median in-network rate greater than $1,250.
TMA has been fighting hard this year to ensure that HR 3630, along with a similar Senate bill, takes the patient out of the middle of out-of-network payment disputes but doesn’t give health insurance companies complete control over what they pay out-of-network physicians.
TMA, the American Medical Association (AMA), and much of organized medicine have backed a different approach: the Protecting People from Surprise Medical Bills Act, sponsored by Congressmen Raul Ruiz (D-Calif.) and Phil Roe, MD (R-Tenn.).
That measure features a “baseball-style” arbitration process for out-of-network billing disputes on state-regulated plans. It’s based on a model that’s been in place in New York since 2015 that has saved that state more than $400 million in emergency services and reduced out-of-network billing by 34%, New York's Department of Financial Services says.
“There IS a way out of the surprise medical bill quagmire. There IS a way to protect patients from unexpected bills for emergency or out-of-network care. There IS a way that does not tilt the marketplace too far in favor of insurance companies or physicians and providers,” Dr. Fleeger’s letter said. “And there IS a way to do it all, and it’s based on a proven model that’s already in place and working.”
As part of that effort, you are encouraged to contact your U.S. representative to support the Protecting People from Surprise Medical Bills Act. To learn more about the Ruiz-Roe bill and its competitors, see TMA’s Surprise Billing Congressional Handout or the AMA’s Surprise Billing Action Kit.