A spokesperson for the Council for Affordable Health Coverage (CAHC) says that the simplest solution to surprise billing, banning it outright, is the best solution, however the health system lobby is slowing down efforts in Congress to enact such a ban.
"A clean ban on surprise billing is the best way to decrease these bills," Greg Johnson said. "There is bi-partisan support in Congress and the President also supports this simple solution. Positive movement is stalling because the health system lobby is trying to water down the bill with a bureaucratic solution called 'arbitration,' which only causes confusion for patients."
Johnson said a simple ban on surprise billing would save $25 billion.
"The health system lobby is very politically powerful and will portray this 'solution' as a win-win. The reality is they hope a complex process will be a hurdle for patients to get relief from their surprise bills," Johnson said.
Last week, the House Energy and Commerce Committee approved its version of a bill that would curb surprise medical billing legislation.
The House of Representatives began their summer vacation this week so it will be a while until there is more action on this legislation. There is a similar bill in the Senate that is also going through committee.
Surprise bills are defined as unexpected and usually exorbitant charges that some patients get after receiving care from a doctor or a hospital that is not in their insurance network.
Reps. Raul Ruiz (D-Calif.) and Larry Bucshon (R-Ind.) added an amendment which added a backstop to the measure’s benchmarking approach.
A Kaiser Health News story explained how the backstop worked.
"The doctor’s payment would still be based on a benchmark, but if he or she thinks that isn’t high enough, the physician can appeal to an arbitrator," the story said. "This backstop could be used only if the dollar amount in question is more than $1,250, and the arbitrator can consider only the complexity of the case and the quality of care."