As the end of the legislative session approaches, the Health Care Conference Committee charged with reconciling the House and Senate passed health care bills is in active negotiations. The time for them to hear the voice of emergency physicians on Out-Of-Network (OON) is now.
The Senate bill would charge the Health Policy Commission with setting rates of reimbursement in instances where there is no contract between the provider and insurance carrier. The House bill proposes a one-year interim approach allowing the option of reimbursement based on the greater of 115% of the average rate the carrier pays for that service and 135% of Medicare. MACEP was instrumental in improving the House language with an amendment that was ultimately adopted by the full House prior to passage.
MACEP strongly supports no action on OON during these unprecedented times. If the committee chooses to move forward, the House language is the better approach. The current state of emergency and tenuous economic landscape for hospitals and the health care system as a whole lends itself to a cautious, interim approach that will allow for more thoughtful, deliberative discussion over the next year.
We need your help in communicating this message to House and Senate leadership and key conferees. The more they hear the voice of emergency physicians, the better chance we have of prevailing.