GNYHA firmly believes that patients should be protected from surprise medical bills, and the last several weeks have been extremely consequential for surprise billing legislation. The most notable development is that surprise billing legislation wasn’t included in Federal fiscal year (FY) 2020 spending agreement reached earlier this week (see above for further details). We were particularly worried about this issue when, on December 9, House Energy & Commerce Committee Chairman Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) and Senate Health, Education, Labor & Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) announced a bipartisan deal on surprise billing. Unfortunately, their compromise contains multiple GNYHA-opposed provisions that needlessly harm hospitals for the benefit of for-profit insurers. This bill is one of several on Capitol Hill that the Congressional Budget Office (CBO) believes will save the Federal government money—making it an appealing option for those who want to use surprise billing legislation to pay for other priorities in a larger package. GNYHA and our allies have been extremely engaged on Capitol Hill in opposition any misguided legislation. We are grateful to Senate Minority Leader Chuck Schumer (D-NY) for his unwavering commitment to New York’s health care community.

Fortunately, other lawmakers have supported other surprise billing proposals that don’t needlessly harm providers. On December 9, 43 House members sent the attached GNYHA-supported letter to House Leadership calling for surprise billing legislation that includes a balanced independent dispute resolution (IDR) process and a meaningful appeals process. On December 11, House Ways and Means Committee Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX) released a summary of a proposal to address surprise bills. While the committee has not yet released legislative text, we are encouraged by aspects of the summary and believe this is a positive development.

Surprise billing legislation will have an immense impact on the United States’ health care industry and must be done correctly. It is imperative that legislation that becomes law doesn’t needlessly benefit for-profit insurers at the expense of providers. We are very pleased that surprise billing legislation wasn’t used as a pay-for in the FY 2020 appropriations process, and now Congress must slow down and work together with all stakeholders to craft effective legislation that is fair to providers.

We are grateful for GNYHA members’ continued outreach to Capitol Hill on this issue, and we implore you to remain active. Please feel free to use GNYHA’s position paper on surprise billing legislation in your advocacy efforts. We will keep you all updated as the extremely fluid surprise billing debate continues.