Congress is expected to pass legislation around surprise medical billing in its COVID-19 year-end relief package, The Hill reported Dec. 20.
The bipartisan legislation, if passed, will ban surprise billing and save patients thousands of dollars from going to an in-network facility but receiving care from an out-of-network provider. Legislators expect to vote on the COVID-19 relief package the week of Dec. 21.
The legislation was developed over several years and was fiercely debated in the last few months. Healthcare-focused lobbyists, including insurers and physicians, worked to influence any surprise billing legislation. Physicians were worried about what they'd be paid once the practice was banned.
The version included in the relief package favors physicians. In a surprise-billing situation, an arbitrator will determine how much the insurer will pay the physician. Notably, the arbitrator also will not be allowed to consider Medicare and Medicaid payment rates. A previous version of the legislation would've set a payment rate by using median rates by geographic area.
Speaker of the House Rep. Nancy Pelosi, D-Calif., said to The Hill, "We're very proud that surprise billing is a part of this."