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INDIANA ASSOCIATION OF PATHOLOGISTS


CAP ACTION ALERT: SURPRISE BILLING LEGISLATIVE PROPOSALS

06 Jun 2019 4:29 PM | Anonymous member (Administrator)

IAP president Shaoxiong Chen received an appeal from CAP's Legislation and Political Action  Manager regarding  proposed bill that will "... allow[s] health plans to unilaterally determine the value of physician services and will turn the physician component of hospital care over to their financial control."

The CAP urges you to "make your voice heard on this important issue that may permanently affect your payment and potentially limit patient access to your services."

Here is the contents of the email:

ACTION ALERT: SURPRISE BILLING

LEGISLATIVE PROPOSALS

You may have seen Congress is quickly advancing surprise medical billing legislative proposals at an alarming rate without properly vetting the potential consequences it could have on your ability to treat patients. Below is a quick recap:

There were several bills and drafts introduced to address surprise billing in both the House and Senate that the CAP has significant concerns with. These legislative proposals include the use of an out-of-network payment methodology exclusively tied to median in-network-rates which is unacceptable to the CAP. It allows health plans to unilaterally determine the value of physician services and will turn the physician component of hospital care over to their financial control. That is a solution that will only benefit the health insurance industry to the detriment of the health care delivery system, and as such, is opposed by the CAP. The CAP cannot support any proposal that supports that provision.

Physician members of Congress, led by Reps. Raul Ruiz (D-CA) and Phil Roe (R-TN), released an outline for legislation that is a positive step in the right direction. As we’re encouraged by the direction of the outline by Reps. Ruiz and Roe, we need you to support them by using the buttons below to contact your member of Congress.

The solutions as proposed by Dr. Ruiz and Dr. Roe would take necessary steps to accomplish our goals of holding patients financially harmless from surprise medical bills while creating a fair reimbursement system that keeps patients out of the middle of billing disputes. In particular, the CAP is pleased to see inclusion of a baseball-style arbitration process that allows consideration for a range of factors, including the usual and customary rate that reflects the market value of physician services. While we are still hopeful that any final proposal will include network adequacy provisions, this is a far better starting point than other proposals we have seen.

Make your voice heard on this important issue that may permanently affect your payment and potentially limit patient access to your services. We look forward to advocating for the Ruiz-Roe proposal to be adopted in place of legislation adverse to pathologists. To contact your legislators now on surprise billing, please click the Send Letter to Legislator(s) button, or if you would like to review and edit the letter please click the Preview/Edit button.

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