December 19, 2019

Surprise Billing Legislation Omitted from Year-End Legislation

Congress will complete its 2019 session this week without advancing legislation to resolve the issue of “surprise medical billing.”

Considered one of the hottest health-related topics before Congress this year, Congressional leaders ultimately determined that the relevant health committees needed more time to coalesce around a final policy solution to protect patients, while also respecting the private market dynamics between insurance plans and providers.

Throughout the year, strong support from the Radiology Advocacy Network (RAN) complemented efforts from the American College of Radiology® (ACR®) government relations team to educate lawmakers about the pros and cons of various proposed policies to address the issue of “surprise” medical bills. In total, more than 2,000 RAN members delivered more nearly 6,500 messages on this topic to Capitol Hill, with a final Dec. push accounting for a majority of the communications. An ongoing collaboration with other physician organizations further amplified these efforts.

The ACR remains committed to working with Congress in the new year to seek a balanced legislative solution to protect patients from unanticipated (“surprise”) medical bills that can occur when gaps in health insurance coverage lead them to receive care from out-of-network physicians or other providers. As deliberations resume in 2020, the ACR will continue to support policy solutions designed to:

  • Protect patients
  • Keep patients out of the middle
  • Ensure reasonable provider payment rates
  • Support a commercial payer claims database
  • Establish a fair, accessible and equitable independent dispute resolution process
  • Safeguard patient access to care

The aforementioned principles are critical to any final, equitable “surprise billing” policy solution and will ensure patients are protected and have access to robust provider networks, while also providing a fair and balanced mechanism for both providers and insurers to resolve billing disputes. The ACR looks forward to continuing to work with Congress to achieve this goal.