Letter to the Editor: Battle to resolve surprise medical billing comes with huge stakes

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To the editor:

There is a battle being fought in the nation’s capital over what should be done to solve the issue of surprise medical billing.

How Congress handles surprise billing will have national ramifications, affecting millions of patients. With what is at stake, the proposed laws deserve sober consideration.

In Washington, many different advocates and voices are weighing in. Insurance companies and their lobbyists insist the answer is to artificially set reimbursement rates for out-of-network providers, establishing a one-size-fits-all rate schedule for care based on the rates for in-network care. The problem this creates is allowing insurers to manipulate the rates, ultimately putting them in their favor.

With this approach, millions of rural Americans could be left out in the cold when it comes to emergency health care if prices are artificially set. Rate-setting would put all the financial burden on doctors and hospitals, and it would put rural patients and providers especially at risk.

The better solution that benefits everyone in the process would be implementing an independent dispute-resolution system, commonly known as an IDR. The system works and is already in use in several states, including New York.

IDR enables an independent third party to make a binding decision based on an independent review of billing disputes. This respected method bases each case on an individual basis and allows all sides of the case to be represented.

In ending surprise medical billing, my hope is that Congress will turn its full attention to solving this problem and not haphazardly tack it onto a broader bill or an end-of-year spending bill.

The health and wellbeing of patients and doctors is much too important for Washington to take a business-as-usual approach.

Thank you,

Dr. Mary Jane Brown

Brentwood

Brown is a practicing emergency physician at Saint Thomas Rutherford Hospital, a member of the Tennessee Medical Association and president of the American Academy of Emergency Medicine’s Tennessee chapter.

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