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AAMS Member Alert: Negotiations on Balance Billing Continue

As of this writing, House and Senate Leadership continue to negotiate the year-end legislative package that will include a continuation of federal government funding as well as a possible COVID relief package. That bill is also the vehicle for the proposed balance billing legislation AAMS reported over the weekend.
 
AAMS continues negotiations and outreach with House and Senate staffs on our concern with the proposal; while AAMS supports the data collection elements on costs, quality, and claims, as well as the considerations of cost, quality, and good-faith efforts to negotiate with insurers as part of the independent dispute resolution (IDR) process, our most significant concern lies with the enhanced influence given to insurers in the IDR process, notably the insurers Median-In-Network. We believe this provision is problematic due to the small pool of in-network agreements and the ability of insurers to lower that payment over time. That provision simply gives too much leverage to insurers over the arbiter’s decisions in the IDR. AAMS supports a fair and equitable process that doesn’t overly rely on the influence of either party.
 
We are also working to ensure that the IDR process is open to any dispute between insurer and provider- including disputes over medical necessity.
 
AAMS must also support the concerns of hospitals and other healthcare providers- hospitals make up the majority of AAMS’ members, and have been vocal about their concerns over the IDR process.
 
You can take action on this important issue by using this: AAMS advocacy tool.
 
The following is the most recent information from Bloomberg Government; AAMS will continue to update the membership as information becomes available:
 
Leaders Close In on Less Than $900 Billion Deal (8:55 a.m.)
Top leaders from both parties in Congress are near a deal for Covid relief of less than $900 billion, including direct stimulus payments but leaving out state and local aid, according to a person familiar with negotiations.
 
Democrats originally asked for nearly $1 trillion in aid to state and local governments to make up for revenue losses during the pandemic lockdowns. More recently, they had pushed for $160 billion in aid, but McConnell tied that provision to a liability shield for companies, which Democrats rejected.
 
A deal today could allow votes as soon as tonight on a bill combining the aid package with the $1.4 trillion bill to fund the government past Friday.
 
Vermont Senator Bernie Sanders had said he would hold up the spending package unless the attached virus-relief deal has direct payments to individuals. The final deal could include this stimulus provision, but less than the $1,200 per person that Sanders requested. -- Erik Wasson





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