�Թϲ�����

Hospitals and doctors on Wednesday scored a slew of amendments that could boost their pay even within the benchmark cap proposed in the House Energy and Commerce Committee legislation to ban surprise medical bills. These amendments, a testimony to the provider community's influence on Capitol Hill, include the option for doctors to appeal to an independent arbiter to collect additional money for certain out-of-network treatment, as well as a potential increase for out-of-network care at pricier facilities. (Luthi, 7/17)

A key change to the bill came in the form of an amendment by Reps. Raul Ruiz, D-Calif., and Larry Bucshon, R-Ind. It would let providers appeal for an independent dispute resolution process for claims over $1,250 in certain cases when a provider says a median in-network rate doesn’t cover its costs. A baseball-style arbiter would weigh proposals by the provider and the insurer before choosing one. The losing side would have to pay for related administrative costs. Ruiz previously said he wanted to offer an amendment on the issue. (McIntire, 7/17)

Kaiser Health News: Surprise Medical Bill Legislation Takes A Step Forward, But Will It Lead To A Step Back?

One of the existential questions of the debate has been how to compensate health care providers if balance billing — which is what happens when patients are responsible for the costs not covered by their insurer — is prohibited. The bill before Energy and Commerce originally included what’s known as “benchmarking” to set the payment amount for out-of-network doctors. So, instead of sending patients a bill for the amount that their health plans don’t pay, a doctor would be forced to accept an amount that is the average of what other doctors in the area are paid for the procedure. (Bluth, 7/17)