“Central to each of these issues is the lack of competition in today’s marketplace, despite the rising cost of health care,” said AAOS President Kristy L. Weber, M.D. “It’s becoming harder for patients to access the high-quality care they need and for our doctors to provide it in a system with restrictive, outdated policies—that’s why we’re here in D.C. this week, advocating for change.”
Two pieces of legislation already introduced in Congress would significantly help to increase industry competition: The Hospital Competition Act of 2019 (H.R.506), introduced by Rep. Jim Banks (R-IN) in January, and the Competitive Health Insurance Reform Act of 2019 (H.R.1418, S.35), introduced by Reps. Peter DeFazio (D-OR) and Paul Gosar (R-AZ) in February.
The Hospital Competition Act would increase patient choice and access to care by lifting restrictions on physician-owned hospitals, discouraging hospital consolidation and certificate-of-need laws, expanding site neutral payments, and increasing price transparency. AAOS strongly supports the bill and is urging others to help ensure the industry is meeting the mutual goal of delivering affordable, high quality care.
The Competitive Health Insurance Reform Act of 2019 would amend the McCarren-Ferguson Act to ensure that federal antitrust laws also apply to the business of health insurance. By providing greater transparency and oversight into the health insurance industry, physicians will be able to negotiate fair reimbursement rates and Americans will have greater access to affordable coverage.
“We are also advocating for the Protecting People from Surprise Medical Bills Act to help solve the increasingly common problem of unanticipated medical bills, which can have a profound effect on both patient health care costs and the physician-patient relationship,” said Dr. Weber. “The compromise solution we support is also being backed by the physician community and uses an arbitration system based on a fair, independent database of charges for common procedures.”
The bipartisan proposal, drafted by Reps. Raul Ruiz (D-CA) and Phil Roe, MD (R-TN), would remove patients from the middle of payment disputes for out-of-network services and hold them harmless. The approach incentivizes insurers and providers to come to the table to negotiate a fair rate and closely mirrors the state of New York’s model which has successfully reduced ‘surprise bills’ by 34 percent.
“We are confident that each of these legislative solutions will move health care in the direction of higher quality and look forward to building congressional support during NOLC,” said Dr. Weber.
The American Association of Orthopaedic Surgeons' (AAOS) Office of Government Relations promotes and advocates the viewpoint of the orthopedic community before federal and state legislative, regulatory, and executive agencies. Based in Washington, D.C., with additional staff in the Academy's headquarters in Rosemont, Ill., the Office of Government Relations identifies, analyzes, and directs all health policy activities and initiatives to position the AAOS as the leaders in advancing musculoskeletal health.