Lawmakers look like they finally have a deal to end surprise medical bills. Here’s how. healthcare
Sen. Lamar Alexander, the top Republican on the Senate health committee, announced the news alongside Reps. Frank Pallone and Greg Walden , the top Democrat and Republican on an important House committee.
Right now, patients can face “balance billing”: a provider not covered by their insurance plan will charge them the full difference — the balance — between what the insurer is willing to pay and what the provider wants to charge. That is how patients can end up with surprise bills for tens of thousands of dollars. Research shows 18 percent of ER visits and 16 percent of in-patient hospital admissions result in a surprise bill of some kind.
arbitration: an independent third party receives input from the provider and the insurer and then decides on what the latter should pay the former So all told, you can see the logic of this compromise. Doctors get arbitration for higher bills . But prices will be set for lower bills, so every single out-of-network bill in the country isn’t subjected to third-party arbitration.
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