- - Monday, October 26, 2020

Throughout the year, Americans have been working to do their part to help take the coronavirus head-on. Doctors and nurses continue working day and night to treat sick patients, while citizens nationwide diligently follow local health guidelines and go in for testing if they feel they may have contracted the virus. However, one important obstacle still remains in making sure people feel completely comfortable visiting their care provider if they are feeling sick: surprise medical bills. 

As more patients have gone in for COVID-19 testing, greater numbers have found themselves stuck with a hefty bill after the fact, despite proclamations from insurance companies and government officials that there would be no charge for the test. It’s caused a great deal of confusion, and could cause major issues for communities across the U.S. if it isn’t addressed quickly. 

This problem is unfortunately not limited to COVID-19 tests, nor is it new. For years, instances have occurred where patients go into the doctor for check-ups or treatments, only to discover after the fact that the doctor they visited was not in their health plan’s network after all. It is a serious issue that not only creates problems for patients’ ability to afford the care they need, but can also mean that doctors struggle to get proper compensation for the services they provide. 

Thankfully, under the direction of President Trump, lawmakers have been working diligently to identify solutions that will finally bring an end to surprise medical billing. Of the proposals that have so far been set forth, there is a clear winner that will protect patients and doctors while holding large insurers accountable: independent dispute resolution.

Independent dispute resolution, or arbitration, is similar to the systems used in states like Florida and New York, where a third party helps to settle disputes between providers and insurance companies without needing to involve patients. It’s a model that has seen great success in the states that have implemented it, and lawmakers would be smart to bring it forward for consideration on the national stage. Arbitration is rooted in proven solutions and will help to ensure patients have proper access to care while doctors receive appropriate payment for their services.

Arbitration would be especially preferred to government rate-setting, which would be disastrous for smaller providers in rural communities. With the government determining rates, insurance lobbyists in Washington would have an unprecedented level of influence in setting rates that are favorable to them rather than to patients or small community providers.

Voters are already well aware of the pitfalls of government rate-setting, as well. Polling from the Taxpayers Protection Alliance shows that respondents oppose government rate-setting by a considerable margin, with it becoming even less popular as the COVID-19 pandemic has gone on. 

Authors of competing surprise medical billing proposals just released a so-called compromise that, unfortunately, falls well short when it comes to protecting patients. The new bills only include weak and inadequate IDR measures and has rate-setting baked into the legislation multiple times. It is only rate setting in disguise: a one-sided proposal posturing as a compromise that will in practice rely on government rate-setting rather than arbitration.

If leaders in Congress like Senate Majority Leader Mitch McConnell, Kentucky Republican, truly want to demonstrate a dedication to reining in surprise medical bills, they will recognize the serious issues at the heart of this bill and reject it in favor of true arbitration. 

With COVID-19 continuing to pose a lingering threat across the country, it is important that people feel they are able to reliably and affordably access the health care services they need. For that to happen, surprise medical bills will need to be brought to heel, and independent dispute resolution will help to do just that. It is the right way to ensure we protect both patients and providers while also guaranteeing large insurers don’t retain an outsized influence in setting rates.

• Matt Mackowiak is president of Potomac Strategy Group, LLC. He’s a Republican consultant, a Bush administration and Bush-Cheney re-election campaign veteran and former press secretary to two U.S. senators.

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