Congress and several states have passed or are pondering measures to ban or limit surprise billing. But these measures have been coming under attack as purportedly unconstitutional. Columnist hiltzikm explains:
Clement hasn’t said whether he wrote his paper on behalf of a particular client. His tone is essentially libertarian, but some of his points already have been aired by doctors and hospitals opposed to balance-billing laws. The challenges include a lawsuit in federal court in Sacramento brought by the Assn. of American Physicians and Surgeons and Eileen Natuzzi, an Encinitas surgeon.
Still, Clement’s points warrant close scrutiny. That’s because they may become factors for Republicans considering a balance-billing measure in the U.S. Senate.of the USC-Brookings Schaeffer Initiative for Health Policy in an analysis posted Monday.“Put most simply,” she wrote, “the Constitution does not protect a health care provider’s right to exploit a market failure to take advantage of consumers.
“Health insurance plans would gain all negotiating power in a regulatory environment where balance billing is unlawful,” he writes. “The credible threat of staying out-of-network and engaging in balance billing thus provides much-needed negotiating leverage for providers.” The quintessential balance-billing victim is someone who suffers an injury, is transported to the hospital in a state of reduced consciousness via an out-of-network ambulance, then returns to consciousness under layers of bills from providers and doctors he or she never had an option of accepting or rejecting.
Among the most problematic are air ambulances, which by law can’t be regulated at the state level. In the wake of a recent Johns Hopkins study showing sharp increases in air-ambulance charges, those services got added to a balance-billing measure under consideration by the Senate Health Committee, much to the industry’s displeasure.
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