CCAGW Urges Ways and Means Members to Oppose H.R. 5825 | Council For Citizens Against Government Waste

CCAGW Urges Ways and Means Members to Oppose H.R. 5825

Letters to Officials

February 11, 2020 

House Ways and Means Committee 
1102 Longworth House Office Building 
Washington, D.C. 20515 

Dear Committee Member,

Tomorrow, you are scheduled to mark-up H.R. 5826, the “Consumer Protections Against Surprise Medical Bills Act” and H.R. 5825, the “Transparency in Health Care Investments Act.” The Council for Citizens Against Government Waste (CCAGW) firmly believes that patients who utilize in-network facilities should not receive a bill from an out-of-network provider unless they agreed to do so before the procedure. Plans and providers should resolve payment issues without federal intervention, but if Congress must intercede, less is better. 

CCAGW is deeply concerned with H.R. 5825, “Transparency in Health Care Investments Act.” The bill supposedly targets “certain investors with respect to certain specified medical care providers” and requires the investors to file separate annual returns that would include proprietary information like negotiated rates, real estate, and other payments to related persons like rent or interest payments. This “Nixontonian” legislation is an invasion of privacy and would stifle investment in healthcare businesses. It would set a dangerous precedent for the government to go after certain businesses that politicians and bureaucrats do not favor. We also believe this legislation may be unconstitutional. CCAGW urges you to vote no on this bill. 

While many have argued for a government-enforced arbitration model instead of price-controls or rate-setting, using binding arbitration is simply delayed rate-setting. The “Consumer Protections Against Surprise Medical Bills Act” establishes a voluntary thirty-day window for open negotiation, but this would simply delay the inevitable use of arbitration. Arbitrators will also rely on area network rates, which will help to drive up costs. The bill allows just the secretary of Health and Human Services to determine whether the selection process is unbiased, which invites more federal meddling.

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.” As a result, “Patients treated at network hospitals never should be balance billed, whether for scheduled or emergency care.” 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 reasonable alternative to the proposal you have before your committee. It protects taxpayers and patients without excessive and unnecessary government intervention. 


Tom Schatz
President, CCAGW

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