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Association of Family Practice PAs & NPs

Fostering the educational & professional interest of Family Practice Clinicians 

Legislation to Protect Patients from Surprise Medical Bills

24 Sep 2019 9:00 AM | Dane Pratt (Administrator)

This is about the efforts to support federal legislation that will protect patients from surprise medical bills.

Roughly 1 in 6 Americans receives a surprise medical bill, usually after seeking emergency care, even though they went to an in-network facility. This is unacceptable, and that’s why we’re asking for your help to fix this problem.

Right now, Congress is considering several bills to end the problem nationally. Unfortunately, some of the proposals would take us down the wrong path by allowing insurance companies to profit at the expense of patient access and quality of care through government rate setting.

The country’s leading medical groups have come out against this plan and instead support an alternative, proven solution: Independent Dispute Resolution (IDR). Under this model, insurers would compensate providers at a predetermined rate, and if the providers can make the case that the services merit another price, then both parties would bring their claims to an independent mediator to resolve the dispute. Meanwhile, patients would be immune from the negotiations and would only pay their normal cost-sharing amount for the care they received at an in-network facility. The IDR method protects patient access and lowers costs while ensuring that medical providers and facilities are able to continue to offer their services to everyone, including underserved communities like patients on Medicare and Medicaid.

See attached for more details! 

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