Healthcare Industry Seeks Surprise Billing Changes This Month

Lawmakers have also been divided over how the administration plans to implement the rule. Education and Labor President Robert C. Scott, D-Va., And senior member Virginia Foxx, RN.C. wrote last month in support of the rule, saying it ” properly balanced the interests of all stakeholders while advancing our bipartite sharing, aiming to minimize administrative burdens and reduce health care costs.

Other members disagree. Last month, 152 other members wrote in a separate letter that the law requires the arbitrator to also consider factors such as provider training and quality of results, complexity of services, parties’ market share and the demonstration of a good faith effort between the parties to negotiate, among others.

The American Heart Association said the administration should keep the rule as written because it would help contain costs to patients and encourage payers and providers to enter into a payment agreement before using the. independent dispute resolution process. The group also urged the administration to invest in a consumer education campaign so people know about the new protections included in the law.

“Strong investments in consumer education will help ensure the [law] works as intended and that patients are aware of their rights and protections, know who to turn to when improperly billed, which will allow for a more complete application, ”wrote Emily Hubolowich, group vice president for federal advocacy.

Jerry Penso, president of AMGA, a professional group representing multi-specialty medical groups, said the group agreed with lawmakers who argued that the arbitrator should consider more factors during the process of ‘arbitration.