As surprise billing ban nears, doctors and hospitals scramble to delay federal law

[Yo_Mama_Been_Loggin]

Nearly 1 in 5 hospital visits result in patients getting the unwelcome surprise of an unexpectedly large bill because doctors or other providers weren't part of their insurer's network.

To protect consumers, Congress passed the bipartisan No Surprises Act last December. But doctors and hospital groups are trying to delay its Jan. 1 rollout over a narrow but crucial portion they contend unfairly favors insurers.

On Thursday, the American Medical Association, American Hospital Association and individual hospitals and doctors sued the federal government to halt federal regulators’ proposed arbitration rules that would effectively end the most common forms of surprise billing.

The proposed rule unveiled by the Department of Health and Human Services and other federal agencies would give providers and insurers 30 days to hash out disagreements over payments or submit to binding arbitration to settle disputes. The lawsuit said regulators misinterpreted the law and proposed an “unfair and unlawful" arbitration system that starts with benchmark rates already negotiated by health insurers – the median, in-network rate for similar medical services.

https://www.msn.com/en-us/news/us/as-surprise-billing-ban-nears-doctors-and-hospitals-scramble-to-delay-federal-law/ar-AARI1ml

[RandomNumbers]

1. For what it's worth

In general, doctors aren't the bad guys here. ("guys" in the gender-neutral sense)

It's the big corporations that are the problem.

It is expensive to become a doctor and stressful to remain one. One problem "Medicare for All" needs to fix is the sometimes ridiculously low reimbursement rates. Otherwise no one using Medicare will be able to rely on decent care. Part of how doctors make it up (at least some I know of), is because they get enough private-pay patients that they can charge more ("gouge", if you prefer).

Back to the main post, I'm just saying it very well may be that the insurance companies got themselves a good deal here.

Do insurance companies even add ANY value to our health care system?

[mopinko]

2. fewer and fewer docs in private practice these days.

if you see a doc in a big system, chances are they are employees. so, yeah, they likely dont have anything to do w the billing.

[napi21]

3. Yes, medicare reimbursements need to be set at a fair rate, BUT who determines what a fair rate is?

Maybe a conference of Insurers. hospitals & Docs could hash it out. It's obviously not right to over bill one group of people! Today Docs bill at a far to high inflated rate, Medicare set it's reimbursement rates too low, & hospitals bill the patient to try to recover their losses, so everybody will have to give a little to even out the burden. Everybody needs to re-asses how they set their rates. After all, for a doc to bill you $300+ for a office visit when it was an annual checkup and everything was deemed just fine is absurd!