WASHINGTON — The $900 billion COVID-19 relief package making its way through Congress includes an end to surprise medical billing, capping off a two-year bipartisan campaign Sen. Maggie Hassan, D-N.H., and colleagues have been pursuing.
The reform made its way into the 5,600-page bill and Hassan said that’s a testament to how much the congressional leadership and President Donald Trump wanted this achievement to be in one of the final acts of lame-duck Congress in 2020.
During a telephone interview Monday, Hassan said the final product was similar to the bill she shepherded through the Senate a year ago with Sen. Bill Cassidy, R-La.
“I felt it was really important we do this in a way that not only saved patients but taxpayers’ dollars as well,” Hassan said.
“Experts have concluded that this approach is likely to save taxpayers $18 billion.”
The deal also made a price accommodation for smaller providers, especially in rural areas, she saired.
“Another goal in this legislation was to protect the smallest providers and allow that their costs might be a little higher so we could keep a balance of urban and rural providers thriving in the health care system,” Hassan said.
Cassidy is a medical doctor while Hassan is both a former governor and an ex-Boston lawyer experienced in workplace and health care lawsuits.
“For far too long, our constituents have done everything right at the doctor’s office or hospital yet still found themselves stuck with surprise medical bills, sometimes to the tune of tens of thousands of dollars and frequently they have to fight these bills at the same time they are facing a medical crisis,” Cassidy said.
Surprise medical bills occur when a patient, usually after receiving a procedure inside a hospital, is charged a high, out-of-pocket amount to cover something done outside the health care network, usually unbeknownst to the patient.
“For surprise medical billing, the key to reform is to get the patients out of this process. You did everything your insurance company told you to do and I heard story after story from constituents who ended up with these charges that they had no way of controlling,” Hassan said.
The COVID-19 relief plan includes $600 stimulus checks for American adults, $300-per-week in additional unemployment benefits, jumpstarting the Payroll Protection Program for business, grants for education, performing arts and health care providers as well as money for COVID-19 vaccines and testing.
Two House panels had turf issues
Hassan said two committees in the U.S. House of Representatives had to resolve differences to reach a deal on surprise medical billing.
The most significant hurdle was whether there would be a benchmark price that insurance companies would have to follow in levying these charges.
The final compromise only requires the average, in-network price be considered and it would permit the health care provider and insurance company to ask an arbitrator to resolve any remaining dispute.
Hassan said she hoped the arbitration option would encourage insurers to include more providers in their networks.
Doctors and hospitals won a key change that the arbitrator could not take into account the rates Medicare or Medicaid charge, which are lower than private insurance payment rates.
The proposal would not start this reform until Jan. 1, 2022.
“We wanted to give the system a year to prepare for this change,” Hassan said.Last year, executives mounted a $30 million ad campaign against the measure which tied it up in the House.
“We had a whole group of bipartisan senators working on this. This is something that impacts Americans from all walks of life,” Hassan said.
“This is a really good step forward. I wanted people to know that their voices had been heard. It’s really good to know people from both parties were able to come together.”
Sen. Jeanne Shaheen, D-NH, also made this issue a priority of hers.
During her re-election campaign last fall, she aired a commercial featuring Kathy Cavallaro of Rye who said she got a bill for $5,000 after having emergency surgery in January 2019.
“I got a bill for an extra $5,000. We went to Jeanne Shaheen, and she got the bill reduced,” Cavallaro said in the 30-second commercial.