Witnesses included representatives from the American Hospital Association (AHA), Aledade, the American Enterprise Institute, the Pacific Business Group on Health, Families USA, and the Office of the Montana State Auditor.
In their opening statements, Chair Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) highlighted the strong bipartisan cooperation in drafting the legislation, as well as the years of Committee hearings that occurred during the development of the legislation. Alexander emphasized that “up to half of the $3.5 trillion the U.S. spent in health care in 2017 was unnecessary.” Murray stated that while the legislation was a step in the right direction, in order to really bring down the costs of health care, this legislation could not be the last step.
Most of the questions from the Committee focused on the three surprise billing options included in the discussion draft [see Washington Highlights, May 24]. AHA Executive Vice President Tom Nickels stated that the “reliance on a benchmark payment rate for providers is unworkable, and we strongly urge the committee to reconsider.” He added that “arbitrary, government-dictated reimbursement would result in significant unintended consequences for patients and create a disincentive for insurers to maintain adequate provider networks.”
Several senators on the Committee agreed with Nickels, including Sen. Maggie Hassan (D-N.H.), who has proposed her own bipartisan solution to surprise medical bills with Sen. Bill Cassidy (R-La.). Hassan stated, “It has become clear that there’s no benchmark payment rate that plans and providers can agree would be an appropriate one-size-fits-all approach.” She continued, “Given the lack of consensus around what a correct benchmark payment rate would look like, it seems unwise to me for Congress to legislate an inflexible benchmark.”
During the hearing, Alexander asked Nickels about the 340B Drug Pricing Program and whether hospitals should be reporting additional information to the Health Resources and Services Administration, which administers the program. Nickels highlighted the AHA’s voluntary initiate and said they plan to share the list of all 1,100 hospitals that are participating by the end of the summer.
Murray began her questioning by dismissing the need for additional reporting requirements, noting, “340B is one of the most effective programs at managing high drug costs that we currently have and there aren’t any taxpayer funds involved in providing these discounts.”
Following the hearing, the HELP Committee officially introduced its legislation, which includes a benchmark rate to resolve surprise billing disputes. The legislation brings the HELP Committee in line with surprise medical bill legislation that was introduced in the House last month by Energy and Commerce Committee Chair Frank Pallone (D-N.J) and Ranking Member Greg Walden (R-Ore.) [see Washington Highlights, May 17].
The hospital community has repeatedly opposed this approach. The AAMC submitted comments to the HELP Committee urging the Committee to reject benchmark payment setting, and to instead consider an independent dispute resolution process [see Washington Highlights, June 14]. The AAMC also joined other hospital groups in opposing the rate setting provision in the Pallone-Walden in a May 28 letter [see Washington Highlights, May 31].
The AAMC also warned the Committee that numerous proposals in Title III, which addresses price transparency, would be burdensome to hospitals and would stand to make care more complicated for both providers and their patients.
The legislation includes funding for Community Health Centers, Teaching Health Centers, and National Health Service Corps for five years at their current levels, which are set to expire on Sept. 30 [See Washington Highlights, February 1]. The bill also amends Title VII of the Public Health Service Act by removing provisions regarding pediatric rheumatology and including a grant for the “training of health care professionals to reduce and prevent discrimination (including training related to implicit biases) in the provision of health care services related to prenatal care, labor care, birthing, and postpartum care.”
The Committee intends to hold a markup on the legislation June 26.