This week, a House Appropriations subcommittee will hear SB 172, which provides an independent dispute resolution (IDR) process as an alternative way to solve the problem of surprise billing. SB 172 breaks the stalemate between insurers and healthcare providers and avoids the need for the General Assembly to establish payment rates in the statute.
- SB 172 passed the full Senate 36-4 and is the only option on the table to end surprise billing.
- The bill is supported by Virginia's chapter of the American College of Emergency Physicians (VACEP), the Medical Society of Virginia, physician specialties, hospitals, and patient advocacy groups.
- We were able to defeat the insurers' bills that wanted to set out-of-network rates at the lower of 125% of Medicare or the in-network rate. However, the insurers do not support SB 172, and will not quit trying to get their payment benchmark to be the solution.
- SB 172 uses an arbitration model that has been very successful in stabilizing emergency care in other states, but in a manner that is specific to Virginia.