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The Devil You Know: Is the Ways and Means Surprise Billing Proposal Actually Good for Doctors?

03.18.2020

Throughout the surprise billing fight of the past 14 months, special interests have poured millions of dollars into lobbying and advertising to move the legislation in their direction. This is not surprising given that billions of dollars of taxpayer and consumer money are at stake. In one corner, health insurers, employers, and labor groups have urged Congress
to adopt a market-based automatic payment rate. Providers, including hospitals and physician groups, have pushed Congress instead to use an independent dispute resolution (IDR), or arbitration, process to settle bills.

For most of the debate, providers’ ambitions have been frustrated as two leading committees of jurisdiction
— the Senate Health, Education, Labor and Pensions (HELP) Committee and the House Energy and Commerce (E&C) Committee — marked up legislation that relies predominantly on the market-based automatic payment. In February, however, providers got the bill they were looking for — a proposal from the House Ways and Means (W&M) Committee that relies more heavily on arbitration. Many provider groups lined up in support of the W&M Committee bill. The same week, the Education and Labor (E&L) Committee marked up a bill that is substantially similar to the bill approved by the E&C Committee.

For more information on the differences between the various proposals, see our policy analysis, Comparing Federal Surprise Medical Bill Proposals: How Do Consumers and Families Fare in the Current Debate?

Yet a closer look at the W&M Committee package begs a critical question: Are health care providers really better off with the bill?

Click the download button below to view the full Analysis.