POLICY BRIEFING: Next coronavirus response legislation in Congress could include measures to control surprise billing

Advocates of long-debated legislation to control surprise medical billing are trying to add it to the third coronavirus package being written by Republican senators, sources close to the negotiations told Inside Health Policy. "Also uncertain is the fate of pending drug-pricing legislation," Ariel Cohen reports. For surprise billing, the package "is viewed as the last vehicle for the legislation for some time," Cohen writes. "There’s no telling when lawmakers will return to the Capitol due to the global pandemic."

The billing legislation would use a plan "favored by insurers because it relies on a benchmark payment rate before moving to arbitration for out-of-network charges," Cohen reports. "Hospitals and providers prefer surprise-billing fixes that rely more heavily on arbitration. . . . Lawmakers are presenting the measure as part of the bailout to hospitals," which "are going to have to make a choice," an unnamed insurance lobbyist told Cohen. "Do they defeat surprise billing or say we’re getting a lot here, let's not rock the boat too hard'?"

The surprise-billing measure "includes a benchmark payment rate to resolve air ambulance payment disputes," Cohen notes. "Air ambulance providers have lobbied against the policy because they say it could lead to air bases closing in rural areas."