House Ways and Means Committee Chairman Proposes New Approach to End Surprise Medical Bills

October 2019 ~

In a letter to the House Ways and Means Committee, Chairman Richard Neal has proposed that the Departments of Health and Human Services (HHS), the U.S. Labor and Treasury Department, along with other interested parties, consolidate their efforts to develop standards for rates for surprise bills.

In his letter, Neal suggests that the three agencies need to work out a compromise that will address provider demands for an arbitration process instead of a benchmark out-of-network rate.

The negotiated rulemaking process would require the agencies to form a committee to identify standards for rates for surprise bills and create a “negotiated rulemaking” process to work out their differences regarding out-of-network rates. It would be up to the committee whether to add a dispute resolution and to define the parameters of that resolution process “within certain predefined parameters that ensure healthcare costs will not increase from the process.”

According to Neal, the proposed process has already been successfully used in the healthcare context, such as Medicare for the clinical laboratory fee schedule improvements and the design of the durable medical equipment payment system. “It is a structured process, allowing for the disagreements to be reached and finalized in a timely manner,” Neal wrote in the letter.

Recommendations would then be provided to the secretaries of federal agencies, who would publish a proposed rule with the opportunity for public comment. The result would go through a public comment period, at which time stakeholders will also be allowed to weigh in on the proposed recommendations.

Neal wrote in the letter that he is “optimistic” that other representatives will agree to his proposal and that legislative staff will be working on the proposed compromise over the current two-week recess period.



Source(s): Becker’s Hospital Review; FierceHealthcare; The Hill;