Authors Dan Choi, MD
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THREAD - Doctors want to fix “surprise bills” more accurately called unpaid insurer bills but today’s “agreement” is NOT the right fix for patients
It’s just a big boost to insurer profits & will shutter independent physician practices & rural hospitals!
1/x
The Independent Dispute Resolution (IDR) in this compromise directs arbiter to consider “in network median rates” when settling disputes which is a sham arbitration & tantamount to benchmarking aka rate setting
Who dictates in network rates?
Insurers!
2/x
This bill prohibits use of charge data (aka usual & customary) which is another way of saying doctors must accept whatever poor contract terms or low balled payment offers insurers are jamming down their throats
This is just giving more power to profitable insurers
3/x
The reason why arbitration works in states like NY, TX is that it levels playing field, directs arbiters to consider independent price database like @FAIRHealth that can’t be manipulated by either side
Insurers have total control over “median in network” rates w their monopolies
When insurers have control over terms of arbitration, they will do everything in their power to do what any respectable publicly traded corporation will do: tilt the terms in their favor to increase
It’s just a big boost to insurer profits & will shutter independent physician practices & rural hospitals!
1/x
Just joined other House and Senate leaders in announcing a surprise billing agreement. Under this agreement, the days of patients receiving devastating surprise out-of-network medical bills will be over. https://t.co/HELY6OiPtS
— Rep. Frank Pallone (@FrankPallone) December 12, 2020
The Independent Dispute Resolution (IDR) in this compromise directs arbiter to consider “in network median rates” when settling disputes which is a sham arbitration & tantamount to benchmarking aka rate setting
Who dictates in network rates?
Insurers!
2/x
This bill prohibits use of charge data (aka usual & customary) which is another way of saying doctors must accept whatever poor contract terms or low balled payment offers insurers are jamming down their throats
This is just giving more power to profitable insurers
3/x
The reason why arbitration works in states like NY, TX is that it levels playing field, directs arbiters to consider independent price database like @FAIRHealth that can’t be manipulated by either side
Insurers have total control over “median in network” rates w their monopolies
When insurers have control over terms of arbitration, they will do everything in their power to do what any respectable publicly traded corporation will do: tilt the terms in their favor to increase