27 Senators sign a bipartisan letter supporting inclusion of the recently-announced surprise billing agreement in the year-end spending legislation: cassidy.senate.gov/imo/media/doc/…
Unfortunately, the AMA is opposing the bipartisan surprise billing legislation.
Interestingly, they previously seemed to support the Neal/Brady bill (left), and the new bill is identical other than a couple concessions to provider lobbying.
The way this is written, you’d think AMA and other provider groups weren’t the ones pushing arbitration (and the administrative headache that goes along with it) this whole time.
Although AMA makes a valid point on the provider directory provision.
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Surprise billing would be prohibited for all OON emergency services (& post-stabilization), much OON care at in-network facilities, & air ambulances.
Out-of-network payment can be challenged to an arbitration process that's instructed to mainly consider median in-network rates.
Arbitration can be a bit clunky & opaque (& adds administrative cases), but the legislation does a pretty good job placing guardrails on the process to prevent abuses.
1) There's a strong anchor to median contracted rates
While the debate has largely broken down as benchmark vs. arbitration, much more important is how generous the out-of-network payment mandate ends up being.
E.g., arbitration based on Medicare rates would be more consumer-friendly than a benchmark based on charges.
Or to take concrete state examples, CT's surprise billing law that uses an OON benchmark payment mandate at the 80th percentile of charges for emergency services is just as bad for consumers as NY's that relies on arbitration to get to the same end state.
Or in a more consumer-friendly fashion, NH's law that strongly anchors their arbitration process to median in-network rates ends up pretty similar to CA or OR laws that get to a similar place through a benchmark.
First, the paper itself provides some great new descriptive work on physician salaries that should prove valuable for future research, but I don’t think it tells us much about the normative question of whether doctor pay is too high/too low.