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December 9, 2019

Over the weekend, key lawmakers announced they had reached a deal on revisions to legislation aimed at lowering health care costs, including provisions that address surprise billing.

The agreement—crafted by Senator Lamar Alexander (R-TN), chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, and Representatives Frank Pallone (D-NJ) and Greg Walden (R-OR), the leaders of the House Energy and Commerce Committee—comes after efforts by both committees stalled this summer over how to settle surprise billing disputes between insurers and providers.

The text of the agreement has not yet been released. While it will reportedly “end surprise billing” and establish “a new system for independent dispute resolution often called arbitration,” no further information was provided as to how the bill’s arbitration mechanism would operate (e.g., the provider-favored, open-ended arbitration; a benchmark rate as a starting point followed by arbitration in unresolved cases; or some other approach).

In addition to addressing surprise billing, the agreement is expected to also contain provisions that:

  • Increase prescription drug cost transparency;
  • Increase the minimum purchasing age of tobacco to 21; and
  • Fund public health programs, including community health centers.

The legislative package may still face some hurdles, as Senator Patty Murray (D-WA)—the top Democrat on the Senate HELP Committee—has not yet signed onto the deal and may be interested in seeing additional changes. Nonetheless, the champions of this legislation remain hopeful that it will be signed into law by the end of the year.

The Council will continue to update its members as details about the legislative package are released.