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Congressional action on surprise billing, GME, geographic disparity

The Wisconsin Medical Society is weighing in on several surprise billing proposals working their way through Congress—and seeing positive progress towards increasing the physician workforce and remedying reimbursement disparities in Wisconsin.

Surprise billing is being spotlighted this week by the “Lower Health Care Costs Act” (LHCCA, S. 1895) in the U.S. Senate, which addresses not only surprise billing, but also lowering the cost of prescription drugs, improving transparency and improving public health. The Senate bill contains a provision to reconcile out-of-network payments at a benchmark in-network rate. The Society, and many other stakeholders, are requesting this provision be amended to allow for arbitration between physicians and payers. The Senate Health Education Labor and Pensions Committee held a hearing on Wednesday June 26 to discuss the LHCCA. Prior to the hearing the Society reached out to committee member Sen. Baldwin and the offices of Chairman Sen. Alexander and Ranking member Sen. Murray urging them to move away from a benchmark for surprise billing.

Please contact Senator Baldwin at 202.224.5653 and Senator Johnson at 202.224.5323 ask them to support legislation including an independent resolution process between physicians and payers. One size fits all benchmark rates will not improve network adequacy.

In the House of Representatives, three surprise billing proposals are currently in committee. They are:

An alternative and preferred approach to surprise billing, the “Protecting People from Surprise Medical Bills Act” is authored by two physician members of the House and would create an independent dispute resolution (IDR) process for surprise bills. Specifically, it would create a “baseball style” arbitration for surprise bills that is modeled on the state of New York process.

The Society also achieved a critical milestone on Wednesday in growing the physician workforce and remedying the Geographic Practice Cost Index (GPCI) disparity in Wisconsin. The House Ways & Means Committee unanimously approved a Medicare extenders package of bills, known as the BETTER Act of 2019 (H.R. 3417), which included an increase to the number of full-time equivalent residents allowed to be funded in underserved rural areas, and extending the GPCI reimbursement floor until 2023. The Committee also advanced a bill that would create 1,000 new residency slots to help address the opioid crisis. These bills are significant because they increase patient access to care and reward physicians for providing high quality care. Their advancement is a testament to the sustained physician advocacy on these issues. The BETTER Act was favorably reported by the Committee, and both it and the opioid residency bills will now head to the House for a vote. In addition, the Society would like to thank Rep. Ron Kind for his leadership on these issues and his mentioning of the Society as a partner during Wednesday’s deliberations.

The Society will be monitoring all bills as they move through Congress.

If you have questions about any of the bills moving through Congress, please reach out to either Lisa Davidson or HJ Waukau.

Back to June 27, 2019 Medigram