FMA Leaders Address Out-of-Network Billing Issues Before Congress in Washington, D.C.

From left to right: FMA Director of Health Care Policy and Innovation Jarrod Fowler, FMA Vice Speaker Ashley Norse, MD, and FMA President-Elect Ronald Giffler, MD, were in Washington, D.C., earlier this week to address out-of-network billing policy issues currently before Congress.

s many of you know, Congress has been moving Given the crucial importance of establishing the right solution, swiftly to address the issue of out-of-network billing FMA President-Elect Ronald Giffler, MD, FMA Vice Speaker with strong support from the White House and a Ashley Norse, MD, FMA Director of Health Care Policy Abipartisan, bicameral group of lawmakers. Unfortunately, the and Innovation Jarrod Fowler, and FMA contract lobbyists legislative proposals that have gained the most momentum Erika Long and Sam Ranson spent Monday and Tuesday in thus far would harm physicians and patients by establishing Washington, D.C., working to educate policymakers on our the median in-network rate as a benchmark for out-of-network position. This trip included meetings with legislative staff from payments, failing to address the network adequacy issues that numerous members of the Congressional Delegation, including Rep. , MD (R-FL-02), Rep. lead to out-of-network bills, and offering limited or nonex- (R-FL-12), Rep. Cathy Castor (D-FL-14), Rep. istent access to an equitable independent dispute resolution (D-FL-27), Rep. (D-FL-07), Rep. Debbie (IDR) process. Wasserman Shultz (D-FL-23), Rep. (D-FL-09), Sen. The FMA believes that the direction Congress is taking currently (R-FL), and Sen. (R-FL). Additionally, is unacceptable and is advocating instead for a solution modeled your FMA team met with staff members from key lawmakers’ offices and committees that are central to this legislation, after successful New York legislation, which includes a charge- including staff from Sen. Bill Cassidy’s (R-LA) office, and based payment benchmark, network adequacy requirements, from the influential House Energy & Commerce Committee and a “baseball-style” arbitration system. This model has and Senate HELP Committee. While these meetings revealed served physicians and patients in the state of New York well by that the legislative process around out-of-network billing will removing patients from insurance disputes without increasing be challenging, the FMA will continue to prioritize this issue premiums or forcing physicians to accept unreasonable fees. and do everything possible to drive the conversation toward Bipartisan federal legislation that includes numerous aspects legislation that protects the practice of medicine and holds of New York’s law is being introduced by Rep. Phil Roe, MD insurers accountable. We will provide additional updates on (R-TN) and Rep. , MD (D-CA), with support from the our advocacy efforts as the multiple proposals currently before FMA and many other medical societies across the nation. Congress make their way through the legislative process.