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In Major Step Forward to End Surprise Medical Billing, Senate HELP Committee Holds Hearing on Bipartisan Health Costs Legislation


To watch Senator Hassan’s questioning, click here.

WASHINGTON – Senator Maggie Hassan today joined her colleagues on the Senate Health, Education, Labor, and Pensions Committee in holding a hearing on ending the practice of surprise medical billing – an important step in Senator Hassan’s bipartisan efforts to pass legislation to end this absurd practice.

“People get health insurance precisely so they won't be surprised by health care bills,” Senator Hassan said in her opening remarks. “So it is completely unacceptable that people do everything that they're supposed to do to ensure that their care is in their insurance network and then still end up with large, unexpected bills from an out of network provider. As has been mentioned, I have been working with Senators Cassidy, Murkowski and others to address this issue in a bipartisan way. We have worked for over a year now on this issue, and received and incorporated feedback from many of you on this panel. And I am grateful for your testimony, and this hearing is an important step forward as we work to protect consumers and end surprise medical billing.” 

During her questioning, Senator Hassan emphasized the benefits of using an independent dispute resolution framework given the lack of consensus around what a correct benchmark payment would look like. The bipartisan STOP Surprise Medical Bills Act that the Senator introduced with a bipartisan group of colleagues would include a backstop allowing providers and plans the opportunity to appeal payment amounts through an independent dispute resolution process. The STOP Surprise Medical Bills Act now has 24 cosponsors in the Senate.

“My colleagues and I in our bipartisan working group agree that patients must be removed from surprise billing disputes. But it has become clear that there's no benchmark payment rate that plans and providers can agree would be an appropriate one-size-fits-all approach,” Senator Hassan said. “During your time at the Centers for Medicare and Medicaid Services (CMS), you experienced firsthand how difficult it is to set uniform payment rates that work well throughout the country. Can you briefly touch on why that work was so challenging,” Senator Hassan asked Sean Cavanaugh, former Director of Medicare Services.

Mr. Cavanaugh responded, “If you were to go the benchmark route in this legislation…You will run into…unanticipated consequences, and someone is going to need to figure out how to adjudicate all those situations.”

Senator Hassan then asked Tom Nickels, Executive Vice President of the American Hospital Association, “Do you believe an independent dispute resolution framework similar to what's already in place or in law in 12 states would be workable for hospitals, providers, and payers and why or why not?” 

Mr. Nickels replied, “Of the three options in the bill, that's the most preferable option…The dispute resolution system, much like in New York state which has proved effective, efficient, etc. would be the best option that is in the bill.”