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Lawmakers push for surprise billing changes as law takes effect

Ariel Cohen, CQ-Roll Call on

Published in Health & Fitness

Back in November, Rep. Brad Wenstrup, R-Ohio, led 150 bipartisan lawmakers in a letter asking the secretaries of HHS, Treasury and Labor to change the rule’s arbitration process.

In some states, insurers cut back their contracted rates to providers in anticipation of the law’s implementation. Blue Cross Blue Shield of North Carolina mandated a 15 percent cut in contracted rates for 2022, citing the surprise billing law as impetus, effectively acting as a cap to payments, according to a November letter from BCBSNC Vice President of Provider Networks Mark Werner that was obtained by CQ Roll Call.

Prognosis

Cassidy doesn’t anticipate the Biden administration taking any action to change the policy unless a court tells it to do so.

“I think we have to allow the courts to play out, and I think that the administration is going to lose,” Cassidy said. “The intent of the law is very clear. It’s very clear, and [the administration] very clearly violated it.”

Several lawsuits on the issue, mostly brought by hospitals and physicians, are moving through the courts at the moment. The suits are all narrowly focused and aim to change the arbitration mechanism of the law without preventing the surprise billing ban from going into effect.

 

The following groups have recently challenged the rule:

•American College of Emergency Physicians and radiology-related groups.

•American Hospital Association and American Medical Association, along with other providers.

•Texas Medical Association, with support from the Physicians Advocacy Institute, along with 13 state medical associations.

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