AAOS concerned about new legislation on surprise medical bills
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The American Association of Orthopaedic Surgeons released a statement thanking Congress for their dedication to find a solution that addresses surprise medical bills by removing patients from the middle of medical billing disputes with the new combined version of the Lower Health Care Costs Act of 2019.
“We appreciate that the new version of the bill includes Independent Dispute Resolution (IDR) as well as a lowered threshold for access to this critical process,” Kristy L. Weber, MD, FAAOS, president of the AAOS, said in a press release. “These positive improvements, however, are overshadowed by the committees’ continued use of the median in-network rate — a number controlled by insurers.”
Weber noted that use of a median in-network rate as a benchmark is similar to government rate-setting, even when filtered through arbitration, and will allow insurers to serve their bottom line by driving down in-network rates, which will harm patient access to care throughout the country. In addition, the effectiveness of the IDR process, meant to bring both sides to the table and incentivize fair, reasonable offers, will be undermined by the proposed 90-day waiting period between disputes for the same procedure types, according to Weber.
“As Congress evaluates this proposal and considers passing legislation before the end of the year, AAOS urges it to incorporate proven solutions like the fair market IDR standard employed successfully in New York,” Weber said. “Using an independent database outside of physician or insurer control is the only way to protect access to care while saving consumers millions of dollars and taking patients out of the middle.”
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