Surprise Medical Billing Legislation

The surprise medical bill issue is at a key juncture in Congress.  The insurance industry is lobbying aggressively for a solution that is based on an artificially low “benchmark payment” to physicians set by and controlled by local insurance companies.  In contrast, ASA is working with our coalition of medical specialty organizations in support of a payment mechanism based on a market-based interim or automatic payment to physicians and a fair appeals or arbitration “backstop” model to contest unfair insurance practices.  Only one side will prevail.  It must be medicine, not insurance companies. What should you do to make your voice heard? Do the following things:

Call to action: Tell Congress to hold health plans accountable for surprise billing

In recent months, Congress introduced a number of bills that address the issue of surprise billing. There is widespread agreement that patients should be protected from surprise medical bills and taken out of the middle of payment disputes. However, the current legislative “solutions” give too much power to health plans. Instead of the discounted in-network benchmark rate solution proposed by many of these bills, MGMA advocates for out-of-network payments to be set by leveraging commercial data from independent sources. When this payment rate is insufficient, an independent dispute resolution process should be utilized to determine fair payment for the physician.

Please take a moment to submit a letter to Congress through our Contact Congress portal and ask your representatives to hold health plans accountable for providing adequate provider networks, so that surprise bills do not ocurr.