@HouseCommerce (Chair Pallone/ Ranking Widen) released #NoSurprisesAct 7/9/19 & #healthplans could not happier: 1. Median contracted rates pegged to ‘19 initially as benchmark—watch out below for the low ball offers this yr; 2. Benchmark adjusted for CPI-U (thx? For what?) ....
(2) Pt cost sharing is this weird form of federalism—the lesser of what the Pt would pay under state law, e.g. CA (125% of CMS) or calculated on median K rates (did I say the health plans are still on a bender from last night over this bill?); 3. 1 of the broadest bans on #OON ..
(3) OON ban includes ED care + any facility care if faculty is In Network services + if there’s no par provider & if the service was the result of unforeseen medical needs + Pt consent & cost estimate for OON service must be 72 hours pre service; does not apply to ERISA plans ...
(4) and no independent dispute resolution (IDR) and therefore no mandatory factors in IDR unlike @CongressmanRuiz bill. Net net—fire up y’all calls to action for Congress to amend this complete unfettered potential victory for the #healthplans. Better stop now before I fall ...
(5) off the #elliptical + its @Wimbledon men’s QF today!
Share this Scrolly Tale with your friends.
A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.