On December 8, 2019, Senator Lamar Alexander (R-TN), Chairman of the Senate Health, Education, Labor and Pensions (“HELP”) Committee, Representative Frank Pallone, Jr. (D-NJ), Chairman of the House Energy and Commerce Committee, and Representative Greg Walden (R-OR), Ranking Member of the House Energy and Commerce Committee, announced that they had reached agreement on legislation designed to lower patients’ out of pocket health care costs, The Lower Health Care Costs Act of 2019.

According to the press release issued by the Energy and Commerce Committee, the bill “would end surprise billing of patients by creating a new system of dispute resolution that includes arbitration, provide nearly $20 billion for five years of funding for the nation’s 1,400 community health centers, and lower the cost of prescription drugs and other medical services by requiring transparency and completion.” The arbitration provision was described as “a new system for independent dispute resolution,” but no further details were provided.

It is significant that Senator Patty Murray (D-WA), Ranking Member of the Senate HELP Committee did not sign onto the bill. Instead, she issued a statement saying: “Senator Murray believes the overall agreement takes important steps forward on a number of issues impacting patients and families and is working with some member of her caucus on concerns they still have.”

Similarly, providers remain concerned that the bill may give insurers too much control over payments to out-of-network providers. In a statement, Rick Pollack, President and Chief Executive Officer of the American Hospital Association said: “Unfortunately, unless this proposal is much improved over previous bills that rely on a benchmark rate, it remains highly problematic and would jeopardize patient access to hospital care, particularly in rural communities.”

The attorneys at Whatley Kallas, LLP will continue to follow this bill through the legislative process and will report on any important developments. For Whatley Kallas’s earlier report on a Health Affairs article that demonstrated that insurance companies are often at fault for the “surprise billing” issue, please click here.