On Thursday, President Donald Trump issued the “Executive Order on An America-First Healthcare Plan.” The order articulates the Administration’s views on a number of health care quality, affordability and access issues.
Of particular interest to ASA, the order includes provisions related to surprise medical bills. The order seeks to encourage Congress to reach a legislative solution to surprise medical bills by the end of 2020. If a Congressional solution is not reached, the order directs the Secretary of Health and Human Services to “take administrative action to prevent a patient from receiving a bill for out-of-pocket expenses that the patient could not have reasonably foreseen.”
ASA has been carefully following the drafting of the Executive Order over the last three days. Earlier proposed versions of the order would have banned surprise medical bills through the addition of requirements to the Medicare Conditions of Participation (CoP). The proposal was viewed as disadvantaging physician practices to the benefit of insurance companies and elicited stop opposition from ASA, other medical organizations and hospital associations. ASA is pleased that the final order permits Congress to continue its work on the issue.
ASA continues to co-lead a coalition of other medical organizations lobbying for a fair solution to surprise medical bills. The coalition’s principles include: protecting patients from surprise medical bills, the use of market-based payment rates, including a market-based upfront or initial payment; a robust independent dispute resolution process that allows physicians to resolve payment disputes with insurance companies; and requirements that require insurers to provide adequate networks of physicians and other health care clinicians.