July 18, 2019

House Energy and Commerce Committee Advances Surprise Billing Legislation with Limited IDR

On Wednesday, July 17, the House Energy and Commerce Committee advanced a legislative package (H.R. 2328) that included an amended version of the No Surprises Act (H.R. 3630), the Committee leadership’s solution for the issue of surprise medical billing.

Of particular importance, Committee leadership agreed Tuesday evening to support a bipartisan amendment, led by Drs. Ruiz (D-CA) and Bucshon (R-IN), to establish a process for independent dispute resolution (IDR) for out-of-network (OON) claims exceeding $1,250. Beyond the option for IDR, the No Surprises Act shields patients from surprise billing by banning balance billing and limiting patient cost sharing when a patient receives OON services and stipulates that OON physicians accept a benchmark payment of median in network rates, with an annual adjustment for inflation.

While the College is concerned that the threshold for IDR is too high, the inclusion of any IDR provision represents a significant step towards establishing a more equitable solution for physicians who provide OON services. The acceptance of the Ruiz/Bucshon amendment is the result of a broad collaborative campaign by the ACR and others in the physician community. As part of the aforementioned effort, the College shared a statement on July 16 urging Committee leaders to amend the No Surprises Act, supported a coalition letter signed by 104 organizations, initiated two calls-to-action and spearheaded many in-person meetings with lawmakers and staff.

Despite the Energy and Commerce Committee having completed its work on this issue, additional opportunities to secure positive changes to surprise billing-related legislation remain. The House Education and Labor Committee shares jurisdiction over the issue and is expected to consider proposed legislation before any bill is advanced to the House floor. The ACR issued a second statement reiterating our desire to work with lawmakers to improve this critical legislation following the conclusion of Wednesday’s mark-up. Negotiations in the Senate are continuing as well, and the ACR Government Relations team will share any relevant updates as they become available.