The current Surprise Billing predicament.
Things were going smoothly. Surprise billing had adversaries closing in on all sides. Proposals from Congressional leaders were taking shape, and it looked like a surprise billing solution was inching closer to the finish line as legislation hashed out the details.
Texas and California make a Surprise Billing push.
Meanwhile, states were making their own push against surprise billing. Texas and California became two of the dozen-or-so states with legislation either partially or fully banning surprise billing practices.
Each state developed its own way to deal with the issue (Texas with third party arbitration between the provider and insurer, California with previously agreed upon, benchmarked median in-network rates for out of network emergency bills). But at least the states enacted the legislation and tried something.
At the federal level, it looks as if we're currently in complete gridlock.
Surprise Billing comes to a not-so-surprising halt.
As Congress returned to class in September after its summer recess, the lobbying scene was flooded with a huge amount of pushback on the surprise billing front.
The culprit? A 'dark money' group apparently backed by major national physician staffing companies.
Given this development, many national media outlets are calling the surprise billing initiatives a stalemate.
Both sides - providers, who favor third party arbitration - and insurers, who favor rate-setting benchmarks for out-of-network care - aren't giving up any ground yet. As you can tell, the issue is quite tricky.
Translation: we might be back to where we started, despite all the back-and-forth rhetoric.
Don't give up on surprise billing yet, though. Congressional leaders in the House launched an investigation into private equity groups that back these physician staffing companies, meaning that at least some want to continue forward.
We'll see if any major surprise billing initiatives come through the federal level. For now, I would turn your gaze toward the states.
TL;DR. Bi-partisan support for surprise billing largely exists and is very real. But insurers and providers can't compromise on a solution. With a new provider group lobbying to take down any surprise billing legislation, we might be in for a long ride.
Thanks for reading - feel free to comment with any recent development I might have left out. If you want to read prior surprise billing developments (i.e., January - this summer), you can read it on the site here.