President Trump calls for an end to surprise medical bills
AHIP wants reimbursement based on market rates determined by contracted amounts paid by insurers to similar doctors in a geographic area.
President Donald Trump on Thursday called for an end to surprise billing, and said an announcement would be coming out within the next two weeks that would be more comprehensive.
"We are going to be announcing something I think over the next two weeks that's going to bring transparency to all of it. And I think in a way it's going to be as important as a healthcare bill, it's going to be something really special," Trump said, after looking over a $17,000 bill for a urine sample that was brought forward by a constituent.
"In an effort to address surprise billing, what we do is all kinds of health insurance: large group, small group, individual markets, everything; we want everything included," he said. "No one in America should be bankrupted unexpectedly by healthcare costs that are absolutely out of control."
Trump said what was coming over the next two weeks would have a bigger impact than a very good healthcare bill and bigger than when his administration took the individual mandate away from Obamacare. It is being drawn up now in a bipartisan effort.
WHY THIS MATTERS
Surprise medical bills hurt patients, providers and insurers.
Patients receive them when they get care, often unknowingly, from an out-of-network provider.
America's Health Insurance Plans has signed on to a letter urging Congress to pass legislation that would prohibit doctors from sending a surprise medical bill to patients in cases of emergency, involuntary care, or instances where the patient had no choice in their provider. AHIP is also urging Congress to require providers to inform patients of their doctors' network status.
AHIP is asking the government to base provider reimbursement on market rates determined by reasonable, contracted amounts paid by health insurers to similar doctors in a geographic area or a percentage of Medicare.
The reimbursement rates should not increase premiums or impact consumer access, AHIP said.
These protections should apply to all health plans, including self-funded plans governed by ERISA, so consumers are protected regardless of coverage type. Complex, costly and opaque arbitration processes, which keep consumers in the middle and lead to higher premiums, should be avoided.
TREND
Trump's comments follow a final rule released Wednesday by Health and Human Services Secretary Alex Azar mandating pharmaceutical companies to post the list prices for drugs that cost over $35 a month, in television ads.
The price and transparency initiatives are based on the President's Blueprint released in 2018 to lower prescription drug prices and healthcare costs.
ON THE RECORD
Ways & Means Committee Chairman Richard E. Neal, a Democrat, and Ranking Member Kevin Brady, a Republican said, "We are committed to working across party lines and with the White House to find a bipartisan solution to protect patients from surprise billing."
"Laying out principles for Congress to address surprise billing is another major step in President Trump's efforts to deliver on this commitment: You, as the American patient, have the right to know what a prescription drug or healthcare service costs before you receive it," Azar said. "We aim to address surprise billing in a way that will protect American patients from this abusive practice and lay a foundation for a system where the patient is put at ease and in control."
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
