Congress needs to resume work on an issue that is heating up in Wyoming and nationwide: surprise medical billing. We can't keep pretending we can solve this on a state-by-state basis; this issue is so widespread that it deserves a national solution.
They have a good start, fortunately, as several solutions have been introduced this legislative session. Now, they must make sure the one they pass doesn't adversely impact patient access to care, especially in rural communities where that is already an issue.
So-called solutions that would seek to solve surprise billing by putting the government in charge of setting rates paid to physicians – through a risky scheme called benchmarking – would end up devaluing the work doctors do by paying them artificially suppressed rates based on highly flawed data from insurance companies themselves.
This approach could end up passing significant financial losses on to our nation's hospitals and other health-care centers. Especially for the ones serving rural communities, which are barely getting by as it is, that could mean cuts to service and staff or even consolidation or closure. Any of these options would mean fewer options and higher prices for patients.
A far better approach can be found in a bill called the STOP Surprise Medical Bills Act, which includes Independent Dispute Resolution as the means by which to protect patients from surprise billing. Unlike benchmarking, IDR offers a way for insurers and providers to negotiate payment terms in good faith. It also helps rural hospitals and emergency rooms benefit from an additional layer of financial stability.
Yet, not all bills that use this IDR approach would have this same positive impact. The No Surprises Act in the House attempts to blend these two approaches, only utilizing IDR when disputed payments are more than $1,250 – automatically negating more than 99% of cases. That means the flawed benchmarking approach would still be used in almost all cases.
For the good of Wyoming patients and rural communities, Sen. Barrasso and Rep. Cheney should champion the true IDR framework in the STOP Surprise Medical Bills Act and encourage their colleagues to do the same.