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AAMC, Hospital Groups Oppose Payment Rate Setting for Surprise Medical Bills

July 31, 2020

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Allyson Perleoni, Senior Legislative Analyst

The AAMC joined eight hospital groups in a July 30 letter to Senate Majority Leader Mitch McConnell (R-Ky.), Senate Minority Leader Chuck Schumer (D-N.Y.), Speaker of the House Nancy Pelosi (D-Calif.), and House Minority Leader Kevin McCarthy (R-Calif.) opposing including a statutory payment rate to resolve surprise medical bills in the next COVID-19 legislative package.

The letter, whose other signatories included America’s Essential Hospitals, the American Hospital Association, the Catholic Health Association of the United States, the Children’s Hospital Association, the Federation of American Hospitals, the National Association for Behavioral Healthcare, Premier healthcare alliance, and Vizient Inc., expressed concern over setting a statutory benchmark rate for payment to resolve surprise medical billing dispute.

The letter says, “Legislative proposals that would dictate a set payment rate for unanticipated out-of-network care are neither market-based nor equitable, and do not account for the myriad inputs that factor into payment negotiations between insurers and providers. These proposals will only incentivize insurers to further narrow their provider networks and would also result in a massive financial windfall for insurers.”

The groups urged Congress to remember that “hospitals are committed to caring for our patients throughout this particularly challenging moment in history” and that they believe that patients should be protected from surprise medical bills through legislation that “would completely remove the patient from the middle of payment disputes between insurers and providers, while also preventing the federal rate setting approach that tilts the scales in favor of insurers.”

The letter follows the release of a White House report on surprise medical billing on July 29 and a joint press statement issued by House Energy and Commerce Committee Chair Frank Pallone (D-N.J.) and Ranking Member Greg Walden (R-Ore.), House Education and Labor Committee Chair Bobby Scott (D-Va.) and Ranking Member Virginia Foxx (R-N.C.). and Senate HELP Committee Chair Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.).

The statement reiterated the congressional members’ support for a legislative solution to surprise medical bills that sets a benchmark rate for payment in statute, stating, “Patients have demanded protection from surprise medical bills for years. They need it in the middle of a global pandemic, and permanently after the crisis is over.” The statement references legislation that their committees have passed over the last year [see Washington Highlights, Feb. 14, Dec. 12, 2019].

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