SUBJECT: STOP Surprise Medical Bills Act
Dear Senators Cassidy, Bennet, Young, Hassan, Murkowski and Carper:
On behalf of the American Association of Neurological Surgeons (AANS) and the Congress of
Neurological Surgeons (CNS), we appreciate your ongoing efforts to address the issue of surprise
medical bills. Like you, we too are concerned when patients receive unanticipated medical bills,
particularly as Americans continue to struggle with rising health care costs, including high deductibles
and other out-of-pocket expenses. As such, addressing issues related to cost-sharing between health
plans, physicians and patients is a priority for organized neurosurgery.
Your legislation, the STOP Surprise Medical Bills Act, is an important step in finding a workable,
balanced solution to this problem, and we are encouraged that the overall framework reflects many of
our principles. Although we have some significant concerns about several aspects of your bill, we are
particularly pleased that the legislation does not embrace either the single medical bill/payment or
network matching approaches that have been promoted by certain stakeholders, think tanks,
commentators and policymakers. Rather, your legislation appropriately incorporates the use of baseball style arbitration, using an independent dispute resolution (IDR) process, as a means of settling out-of-network payment disputes between health plans and providers.
Our principal concerns about the bill as drafted include:
- The use of the median in-network rate as a federal benchmark for resolving payment disputes between health plans and providers;
- Limiting the IDR entity’s ability to consider in-network rates (and not charges) only when making award determinations; and
- Lack of reference to the use of a wholly independent database (e.g., FAIR Health) to determine market-based payments for out-of-network care.
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