by jerry on February 16, 2020
Kaiser Health News published another article in the fight over surprise medical billing, where a patient thinks that s/he is receiving in-network services but is billed at out-of-network rates. Patient frustration with being stuck with large surprise medical bills has mounted enough that legislatures (both state and federal) have considered a variety of bills to address the issue. Now, however, some doctors are lobbying to have such legislation incorporate terms that are more favorable to physicians.
Perhaps not surprising, Kaiser Health News reported that physician organizations that have heavily lobbied for changes in surprise medical bills are related to specialties where the context is time-sensitive (e.g. emergency medicine, anesthesia) -- those specialties probably have a number of physicians that benefit financially from the current confusion.
Surprise medical billing seems like a mostly solvable problem. For example, insurers could require that all services rendered at an in-network facility are billed at in-network rates, thereby pushing the problem to the facility to coordinate and recruit physicians that accept the same insurance plans. In turn, insurers might pay extra for imposing that condition, but their members would be much less likely to be stuck with what they consider an outrageous bill. If this conflict keeps simmering, I expect there to be additional legislative efforts to be considered.