Lawmakers nearing deal to end ‘surprise‘ medical bills

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It’s unclear how the Senate would view this potential deal — representatives for Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer didn’t immediately comment. McConnell earlier this year opposed including a surprise billing fix in a coronavirus relief package, but GOP sources said McConnell likely won’t stand in the way since it’s a priority for Senate HELP Chair Lamar Alexander (R-Tenn.), who is retiring.

The background: It appeared earlier during this Congress that lawmakers had a deal to resolve the surprise billing issue, with the Senate HELP and House Energy and Commerce committees agreeing on a plan. But the bicameral deal was quickly stalled by intense lobbying campaigns and congressional turf battles.

The details of the latest negotiations weren’t immediately clear. Last year’s framework from the HELP and Energy and Commerce committees would settle billing disputes for out-of-network care by paying health care providers a benchmark rate, pegged to local in-network costs for some bills — an approach favored by health insurers but strongly opposed by doctors and hospitals. Bills over $750 could be appealed to an independent mediator.

Neal in the past year has been pushing an alternative provider-friendly approach that would allow all disputed bills to go to arbitration.

Why it matters: Just earlier this week, the issue appeared dead after Neal again rejected the bicameral framework. But Pelosi kept pushing, and Neal has engaged in discussions. Besides Neal’s Ways and Means panel, three other committees are involved in the latest talks: Senate HELP, House Energy and Commerce and House Education and Labor.

Spokespeople for Pelosi and the committees did not provide comment. Alexander on Thursday afternoon told POLITICO his committee is still working with House leaders on securing a deal.

“We’re still working — we’ll see,” Alexander said.

Should the effort fall apart, prospects for a fix in the next Congress are uncertain. Two of the key Republican champions of a surprise billing fix — Alexander and Energy and Commerce ranking member Greg Walden of Oregon — are retiring this year. It is unclear who on the Republican side might take up the charge in the next Congress.



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