CRITICAL STUDIES

DON'T REINVENT THE WHEEL: GEORGETOWN UNIVERSITY HEALTH POLICY INSTITUTE STUDY SHOWS NY'S SURPRISE BILL WORKS

New York's 2014 Law to Protect Consumers from Surprise Out-of-Network Bills Mostly Working as Intended: Results of a Case Study

This study funded by the Robert Wood Johnson Foundation found that consumer complaints dramatically declined after New York implemented baseball style Independent Dispute Resolution (IDR) system to resolve payment disputes between insurers and physicians. One regulator stated that the NY law has downgraded surprise billing "from one of the biggest consumer concerns...to barely an issue."

TOO CRITICAL TO RUSH: CBO IS NOT CONSIDERING ALL FACTORS IN SCORING OF S. 1895

An Assessment of CBO Cost Estimates of S.1895: The Unintended Economic Consequences of the Proposed Healthcare Price Control System

There are many unintended negative consequences of the proposed Senate bill S.1895. It is intended to address surprise medical bills, but in doing so sets price controls for all physicians. The CBO cost-savings estimate is based on unrealistic assumptions and fails to account for the negative impact on the number of physicians nationwide. The unintended consequences are significant. The number of available physicians will drop. Patient quality will be reduced. Healthcare expenses will rise.

BENCHMARKING IS UNCONSTITUTIONAL

Federal "Balance Billing" Legislation: Constitutional Implications

Congressional efforts to address surprise bills raise numerous constitutional concerns. Such legislation threatens to take property from healthcare providers without just compensation, in violation of the Takings Clause of the Fifth Amendment. The constitutional problems are almost certain to worsen over time, and the effects will be felt by in-network and out-of-network providers alike.

 

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