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posted by martyb on Monday October 08 2018, @09:18PM   Printer-friendly
from the meanwhile-don't-get-sick-or-hurt dept.

The bipartisan plan to end surprise ER bills, explained:

The policy proposal, which you can read here, essentially bars out-of-network doctors from billing patients directly for their care. Instead, they would have to seek payment from the insurance plan. This would mean that in the cases above, the out-of-network doctors couldn't send those big bills to the patients, who'd be all set after paying their emergency room copays.

The doctors would instead have to work with patients' insurance, which would pay the greater of the following two amounts:

  • The median in-network rate negotiated by health plans
  • 125 percent of the average amount paid to similar providers in the same geographic area

The Senate proposal would also require out-of-network doctors and hospitals to tell patients that they are out of network once their condition has stabilized, and give them the opportunity to transfer to an in-network facility.

[...] it's pretty good policy too! That's the general feedback I got from Zack Cooper, an associate professor at Yale University, who, along with his colleague Fiona Scott Morton, has done a lot of pioneering research to uncover how frequently and where these surprise bills happen.

"It is fantastic that they're doing something, and that it's bipartisan," he says. "It's one of those areas where we can agree what is happening now is not good, and this gets us 80 percent of the way to fixing it."

[...] "My concern here is that in-network rates are already quite high, so we're cementing that into the system," he says. "The current world gives emergency physicians tremendous power in negotiating higher in-network rates."

See also: Emergency room visit costs: what's the price of care?


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  • (Score: 0) by Anonymous Coward on Monday October 08 2018, @10:54PM (1 child)

    by Anonymous Coward on Monday October 08 2018, @10:54PM (#746189)

    Where does this idea that the US is supposed to be a democracy come from? Just because people vote doesnt make it a democracy.

    In the US the constitution is supposed to trump the will of the people (but there are mechanisms to amend the constitution if enough people want it to happen):

    Government: Federal presidential constitutional republic

    https://en.wikipedia.org/wiki/United_States [wikipedia.org]

  • (Score: 0) by Anonymous Coward on Monday October 08 2018, @11:59PM

    by Anonymous Coward on Monday October 08 2018, @11:59PM (#746215)

    Welcome to the 21st century, Rip van Winkle! I am very sorry to inform you, but for quite a while now, SCOTUS has used the following process:

    1. Would the Ninth or Tenth Amendment prohibit the law? If yes, proceed to the next step. If no, proceed to the next step.
    2. Does the law involve commerce of some kind (interstate, intrastate) or can it potentially involve commerce or is it regard something that somebody could conceivably put up for auction or sell to a neighbor? If yes, the interstate commerce clause allows the law to stand. If no, proceed to the next step.
    3. Is it a state law that upon first glance would be outside of the jurisdiction of the federal government? If yes, the equal protection clause of the Fourteenth Amendment prohibits the law. If no, proceed to the next step.
    4. If yes was obtained for the first step, the due process clause of the Fourteenth Amendment prohibits the law.*
    5. Otherwise, the necessary and proper clause allows it.

    Any questions?

    * Note: Step 4 may be changing soon! Huzzah for ASS-JUSTICE Kavanaugh!