Published 6/20/2019
Washington, D.C. (June 20, 2019) — American Association of Orthopaedic Surgeons (AAOS) President Kristy L. Weber, MD, released the following opposition statement to the surprise medical bill provisions of the recently released Lower Health Care Costs Act of 2019 (S.1895) by the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee:
“While the AAOS supports removing patients from the middle of out-of-network billing disputes, we strongly believe that imposing an insurer-controlled rate is not the solution. The Lower Health Care Costs Act represents an unprecedented transfer of market power by the government to insurers and directly threatens the independent practice of medicine.
“Unlike other proposals being presented, insurers would not be required to negotiate with physicians or even consider the individual circumstances of a patient’s care. Instead, they would have the ability to unilaterally lower rates and effectively create a one-size-fits-all ceiling for reimbursement—leading to smaller insurance networks, fewer physicians in rural areas, less competition in the health care industry, and severely reduced access to care across the country.
“A better solution would incentivize all parties to come to a reasonable agreement and allow remaining disputes to be resolved through a fair “baseball-style” arbitration process like the proven New York Model. AAOS believes that the true source of surprise bills are narrow, inadequate networks of health care providers and setting payment to a median rate will only exacerbate this problem. Congress can and must protect patients from unexpected medical bills without allowing insurers to dictate the cost of services absent any focus on the individual patient or quality of care.”
More on AAOS efforts to stop surprise billing:
“While the AAOS supports removing patients from the middle of out-of-network billing disputes, we strongly believe that imposing an insurer-controlled rate is not the solution. The Lower Health Care Costs Act represents an unprecedented transfer of market power by the government to insurers and directly threatens the independent practice of medicine.
“Unlike other proposals being presented, insurers would not be required to negotiate with physicians or even consider the individual circumstances of a patient’s care. Instead, they would have the ability to unilaterally lower rates and effectively create a one-size-fits-all ceiling for reimbursement—leading to smaller insurance networks, fewer physicians in rural areas, less competition in the health care industry, and severely reduced access to care across the country.
“A better solution would incentivize all parties to come to a reasonable agreement and allow remaining disputes to be resolved through a fair “baseball-style” arbitration process like the proven New York Model. AAOS believes that the true source of surprise bills are narrow, inadequate networks of health care providers and setting payment to a median rate will only exacerbate this problem. Congress can and must protect patients from unexpected medical bills without allowing insurers to dictate the cost of services absent any focus on the individual patient or quality of care.”
More on AAOS efforts to stop surprise billing:
- AAOS Encouraged by Protecting People from Surprise Medical Bills Act
- AAOS Letter to Ways and Means on Surprise Billing Hearing
- AAOS Letter to Senate Working Group on Surprise Billing
- Letter to Congress re: Narrow Networks
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Contact AAOS Media Relations
Kristen Coultas
202-548-4143
coultas@aaos.org