Senate HELP Committee leaders Wednesday unveiled their wide-ranging bill to address health care costs— and settled on a federal benchmark to fix “surprise” medical bills.
The benchmark is pegged to the median in-network rate for an area, the same approach advanced by House Energy and Commerce Committee leaders in a bipartisan discussion draft last month.
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HELP Chairman Lamar Alexander (R-Tenn.) wants to mark up the legislation next week. The committee’s remedy for surprise bills is different than a proposal Alexander said on Tuesday he “instinctively” liked — requiring all physicians at the same facility to be considered in-network.Alexander in a statement acknowledged the change, noting that CBO indicated the benchmarkapproach is “the most effective at lowering health care costs.”
Solving payment disputes between providers and plans — an effort to shield insured patients from high-cost bills for inadvertently seeing an out-of-network provider — was the most contentious part of drafting the HELP bill. The committee had solicited feedback on three different options.
A group of bipartisan senators, led by Bill Cassidy (R-La.), meanwhile has backed a plan featuring an arbitration option.
The health care industry has lobbied intensely on ‘surprise’ medical bills, and hospitals and providers oppose a federal benchmark.
The Senate HELP legislation, co-sponsored by the panel’s top Democrat, Patty Murray (D-Wash.), also aims to increase transparency in the health care system, target pharmacy benefit managers, improve the exchange of health information and address public health issues, like vaccination misinformation and maternal mortality.
A discussion draft of the bill released last month yielded over 400 comments.