No Surprises on Surprise Billing

September 10, 2019 By: Bob Atlas, President & CEO

A bipartisan effort to address surprise medical bills is expected to be among lawmakers’ top priorities when Congress returns this week from August recess.

MHA is engaged on the issue —including the House’s No Surprises Act and Senate’s Lower Health Care Cost Act—and has been since it arose months ago. The chief concern is federal proposals are contemplating using a payer’s “median contracted rate” to settle billing disputes. In our state there are no median contracted rates for hospitals; it’s been that way for the past 40 years under our all-payer rate-setting system.

MHA advocated strongly for the Health Services Cost Review Commission (HSCRC) to conduct a legal review to understand the bills’ impact on our system. HSCRC agreed and found this legislation, if adopted, could be harmful to the Maryland Model.

To prevent adverse effects, we encouraged HSCRC to send a letter to the Maryland congressional delegation. HSCRC requested an amendment to let Maryland retain the authority to determine disputes about rates and settle using our current system.

In support of the HSCRC’s congressional ask, MHA also submitted a letter . We are urging our delegation to consider an amendment to the federal surprise billing proposals. We recommend they make clear that Maryland is except from the “median contracted rate” provision—so insurers continue to pay hospitals HSCRC-defined rates.

MHA will continue to follow the bills and we will advocate to ensure protection of our successful, unique system.