December 13, 2019
Just as a surprise medical billing measure appeared to be inching closer to the finish line, a proposal released by the House Ways and Means Committee introduced yet another hurdle in its path to congressional approval.
House and Senate committee leaders announced a bipartisan, bicameral deal on Monday. The proposal includes:
Proponents argue this approach results in both parties moderating their proposed dollar amounts and lowering health care costs. But a Brookings Institute analysis on arbitration in New York demonstrated that costs actually went up as arbiters typically decided on amounts above the 80th percentile of costs.
HR Policy Association and other employer groups have advocated the use of a benchmark with no arbitration and, if arbitration is included, strong transparency protections should be put into place to ensure bad actors do not consistently use arbitration to drive up prices.
The Ways and Means Committee proposal does not appear to include a benchmark. Instead it states that insurers and doctors should first work out their own payment disputes, and if it cannot be resolved, IDR would occur.
Takeaway: With the significant differences among the proposals and Chairman Neal and Ranking Member Brady stating the issue should be tabled and taken up in the new year, it seems the finish line is farther than we thought.