House Committee Chairman Proposes Negotiated Rulemaking Solution for Surprise Medical Bills

October 04, 2019

With bipartisan legislation on surprise medical bills stalled in Congress, a letter from House Ways and Means Committee Chairman Richard Neal (D-MA) proposes to punt to the executive branch the question of how payment disputes are to be resolved.

To address the “disagreement among stakeholders over reimbursement rates for out-of-network surprise bills and the extent to which a dispute resolution process can determine those rates,” Rep. Neal is proposing to:

  • Protect patients from unexpected costs; and
  • Require HHS, DOL, and Treasury to engage in a “negotiated rulemaking process to require stakeholders to work out their differences” and identify standards for rates for surprise medical bills.

Stakeholders on the rulemaking committee would also determine how and if dispute resolution should be included, within certain predefined parameters that ensure health care costs will not increase from the process.

Ways and Means Committee staff will draft legislative language for the committee to consider before the end of October.

Outlook:  While the House Energy and Commerce Committee has passed a bipartisan bill addressing surprise medical bills, the Education and Labor Committee has delayed action because of a split among its members.  Rep. Neal’s proposal could appeal to those members looking to pass some bill ahead of the 2020 election, without having to make a difficult decision over provider reimbursement rates.  However, it is unclear at this point which approach, if any, will make it into some year-end omnibus bill.