CCAGW Urges House Education and Labor Committee to Oppose HR 5800 | Council For Citizens Against Government Waste

CCAGW Urges House Education and Labor Committee to Oppose HR 5800

Letters to Officials

February 10, 2020

House Education and Labor Committee
2176 Rayburn House Office Building
Washington, D.C. 20515

Dear Committee Member,

Tomorrow, you are scheduled to mark-up H.R. 5800, the Ban Surprise Billing Act. On behalf of the more than one million members and supporters of the Council for Citizens Against Government Waste (CCAGW), I urge you to vote against this legislation. While CCAGW agrees that patients should be protected from surprise billing, implementing any form of rate-setting is a price control, including relying on a so-called “market-based benchmark of the median in-network rate of providing similar items or services in the same geographic area.” Rate-setting would be particularly harmful to patients in rural areas where it is difficult to find, hire, and maintain skilled providers.

Others have argued for a binding arbitration model but, this is rate-setting delayed as arbitrators will also rely on network rates and will help to drive up costs.

There is a third way to solve this problem, proposed by The Galen Institute and The Heritage Foundation as “A Targeted Approach to Surprise Billing.” As Doug Badger explained in a January 30, 2020 “Daily Signal” blog, “The solution to this problem is obvious: truth-in-advertising. Congress should impose penalties on insurers that represent medical facilities – and medical facilities that represent themselves – as being in-network if doctors balance bill patients for services they provide at that facility.” CCAGW believes this approach would encourage medical providers and insurers to come to an agreement before a procedure is undertaken, however they wish to do so.

The only place this would not work is when a patient is experiencing a true medical emergency and must be treated at an out-of-network facility. In these special cases, a possible solution is that Congress could “protect such patients by banning non-network hospitals from balance billing for emergency care. Federal regulations currently stipulate that insurers must pay such hospitals the greatest of the Medicare rate, the network rate or the out-of-network rate.”

We believe this is a fairer and more reasonable alternative to the proposal you have before your committee. We urge you to reject the government-imposed rate-setting price controls in H.R. 5800 and instead consider the truth-in-advertising solution to surprise medical billing.

Sincerely,

Tom Schatz
President, CCAGW

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