There is recent activity in Congress on surprise medical billing.
When I was presented with a patient specimen, I didn’t wait in the laboratory to check the patient’s insurance. I performed the right tests to make a correct diagnosis. The billing for this service comes later.
As pathologists, my colleagues and I support holding patients financially harmless from unexpected out-of-network medical bills. Physicians want to be in-network and accept the insurance plans covering their patients. Often, the health insurer drops physicians or refuses to contract with those who wish to join.
Congress needs to adopt a federal proposal that includes network adequacy standards requiring health plans to contract with the right numbers of physicians practicing at in-network hospitals. Insurers and providers should negotiate reimbursement for services in an equitable manner, without insurers having all the negotiating power.
Congress should establish a fair payment formula for out-of-network physician care and allow a doctor and insurance company to settle a bill through third-party arbitration.
Take a serious look at the proposal of Reps. Raul Ruiz and Phil Roe, which is a positive step in the right direction. I urge Rep. Chris Stewart to support this.
Ronald Weiss, Salt Lake City