Earlier this week, the U.S. House Committee on Education and Labor marked up H.R. 5800, the “Ban Surprise Billing Act,” introduced by Chairman Bobby Scott (D-VA) and Ranking Member Virginia Foxx (R-NC). The legislation passed out of the committee by a vote of 32-13.
The legislation aims to protect patients from receiving surprise medical bills by implementing a federal benchmark payment approach for settling billing disputes. For amounts less than or equal to $750 (or $25,000 for air ambulance services), the legislation relies on a market-based benchmark of the median in-network rate for providing similar items or services in the same geographic area. For amounts above $750 ($25,000 for air ambulance services), the legislation would allow providers and payers to elect to use independent dispute resolution (IDR) to determine a fair payment amount.
Notably, the legislation also includes a provision on transparency that would require disclosure of direct and indirect compensation for brokers and consultants to employer-sponsored health plans and enrollees in plans in the individual market. This language is almost identical to a provision in U.S. Senate legislation on surprise medical billing, S.1895, the “Lower Health Care Costs Act.”
While the Big “I” appreciates the committee’s efforts to solve the surprise medical billing problem, we will continue our dialogue with Congress to improve any language in a surprise medical billing package that would require disclosure of direct and indirect compensation for agents. Any new transparency requirements must be workable and practical for our small business members.
Wyatt Stewart is Big “I” senior director of federal government affairs.