July 16, 2019

House Energy and Commerce Surprise Billing Solution Misses the Mark

The American College of Radiology (ACR) is committed to protecting patients from surprise medical bills. However, ACR has serious concerns with the version of the No Surprises Act (H.R. 3630) to be considered by the House Energy and Commerce Committee in the coming days.

As written, the legislation would result in the federal government setting payment rates for out-of-network (OON) services performed in the in the private market. The ACR and many Americans oppose such government-controlled price setting in the private sector.

In addition, HR 3630 has no mechanism for providers and insurers to directly resolve payment disputes for out-of-network (OON) services. Instead, the legislation sets a benchmark payment rate that can be easily manipulated by insurers, result in market compression, and decrease access to physician services.

The Energy and Commerce Committee should amend the No Surprises Act to include independent dispute resolution (IDR) provisions from H.R. 3502, the Protecting People from Surprise Medical Bills Act. This legislation mirrors the successful surprise billing resolution implemented in New York State and includes robust patient protections that remove patients from billing disputes.

To demonstrate overwhelming support for the inclusion of an IDR process in HR 3630, a broad coalition of provider organizations, including the ACR and an additional 102 signatories, have delivered a letter to Committee leadership urging it include IDR in any surprise billing legislation advanced by the Committee.

The College looks forward to working with Congress and other stakeholders to create a sensible surprise billing solution that works for patients and health care providers.