Congress is working on H.R. 3502, a “Surprise Medical Bill.” I encourage you to support physician reimbursement by contacting your representative in the US House of Representatives.
What this bill would require: Patients who receive medical care would be covered for that care by their insurance, by law. The insurer would be required by the bill to pay a fair and reasonable amount for the care that their insured receive, not denied, and not paid some pittance or some arbitrary amount decided unilaterally by the insurance company.
Why this is important: Currently, when patients come to the hospital for emergency care or for emergency admission, the insurance companies may not cover or pay for the care provided. The insurance company may pay very little, less than the cost of providing the care, or they may pay nothing to physicians who are not in their increasingly narrow networks. This inadequate payment or no payment by the insurance company is made despite the fact that emergency care, emergency hospital admission, and necessary emergency consultations of appropriate specialists are all mandated directly or indirectly by the federal EMTALA law along with state laws preventing patient abandonment without regard to the ability to pay or whether an insurance company will cover the cost of care.
What you can do: Go to the website link below and contact your representative in the US House of Representatives. Please help protect doctors against predatory insurance companies by supporting this law.July 6, 2019 at 4:33 am MST #228146ZZZParticipantStatus: SpousePosts: 542Joined: 06/18/2018
Ah, the auto-fill email to Congress, that powerful tool driving legislative agendas.
The corporate and private equity owned medical ventures that bilk the system with surprise bills are employing far more effective lobbying tools to keep their gravy train going.
Our group is small private group of physicians. This bill would help us too.ZZZParticipantStatus: SpousePosts: 542Joined: 06/18/2018
You missed the point. Emails like this to congressional reps are effectively worthless. The point of this bill isn’t to help doctors, it’s to curtail the sleazy PE and corporate ventures that purposefully stay out of network to bilk the system.
They reap millions by doing that. So, they’ll spend that money on things that actually get congressional reps to vote their way, like campaign $$$ and no show jobs for relatives.
Have you read the bill you’re promoting (prob not since it actually hasn’t been made available as of this AM)?
“This bill will help us, too.” You sure? From what you read in the bill, right? It’s actually likely to be a negative for groups like yours that likely have favorable insurance contract rates.
Read up on it before you go rallying the troops.July 6, 2019 at 8:32 am MST #228192
The hope is that the bill will:
1. Protect doctors from not being paid
2. Protect patients from receiving outrageous bills from providers/corporations that are totally out of line for the services provided
The American College of Emergency Physicians is supporting the bill. Hopefully that’s because they are looking out for the physicians. Of course there could be corporate influence. However, our smaller group has struggled to get reasonable in network rates. We would totally prefer to be in network, but not when the insurance companies are going to screw us by offering much less than the going rate for care.DreamgiverParticipantStatus: PhysicianPosts: 801Joined: 03/09/2017
I posted this 2 weeks ago:
This was the outcome:
Although tying out-of-network reimbursement to Medicare rates was removed from the bill, it still includes rate setting based on median in-network rates and excludes independent dispute resolution, thereby favoring insurance companies in billing disputes. There was discussion of continuing to work with Senator Cassidy, who advocates an arbitration model, as the Senate bill works its way through the legislative process.
On the House side, please contact your representative and encourage him to co-sponsor a bill proposed by Congressman Raul Ruiz MD (D-CA) and Congressman Phil Roe MD (R-TN) Protecting People from Surprise Medical Bills Act. This bill is based on the New York model that protects patients while balancing the interests of physicians and insurance companies. It also creates an Independent Dispute Resolution (IDR) process.