MAG encouraging physicians to educate lawmakers on ‘No Surprises Act’
The Medical Association of Georgia (MAG) is encouraging every physician in the state to reach out to their U.S. representative and U.S. Sens. Johnny Isakson and David Perdue while they are in their home offices for the next month (during their “district work periods”) to discuss the ‘No Surprises Act’ (H.R. 3630), which recently passed the House Energy & Commerce Committee.
This legislation is designed to “protect patients from unanticipated medical bills for services provided by out-of-network physicians and facilities in emergencies and other situations where they have no opportunity to choose an in-network provider.”
MAG believes that lawmakers are generally headed in the right direction with this legislation, including the addition of an appeals process for physicians and other health care providers to resolve out-of-network payment disputes with insurers.
However, MAG is concerned that the measure still includes a flawed “median network average” mechanism to pay physicians who deliver care on an out-of-network basis – a pro-insurer average that often doesn’t reflect the full or true cost of providing the care, can’t be verified, and is easily manipulated.
Encourage your elected officials to…
1. Use fair benchmarks (e.g., that are based on actual local claims charges using an independent database).
2. Use a fair and independent provider/insurer dispute resolution (IDR) process.
3. Get patients out of the middle of the process by making insurers be responsible for the costs they are supposed to cover.
4. Require insurers to maintain an adequate network of physicians, especially in ER settings (e.g., on-call surgeons and anesthesiologists).
You can educate your elected officials by calling or emailing them or writing them a letter, meeting with them in their district office, or attending one of their town hall meetings.
Contact MAG Government Relations Director Derek Norton at firstname.lastname@example.org with questions.
Contact Sen. Isakson by clicking here or calling 770.661.0999 and contact Sen. Perdue by clicking here or calling 404.865.0087.
MAG ‘Surprise Medical Bills’ fact sheet