TRS Members,
Thank you for your support of the PAC this year . Although we can always use more funds we are ahead of contributions for the past several years by a few thousand dollars. It has helped.
Balance (Surprise) Billing remains a foremost issue for us . As you remember this refers to the bills patients receive from out of network providers for the difference between the provider’s charges and amount the insurance carrier pays the out of network provider. To an individual patient this amount might be quite substantial . The issue has caught the attention of legislative bodies across the country including TN (for a more in depth discussion of balance billing click here). This past summer the TN Dept of Commerce and Insurance(DOCI) held meetings which included most of the major stake holders. We were represented by Jim Schmidt, our lobbyist and by Brian Barbeito of MSIT. Recommendations to the Governor’s office by the DOCI favored settlement of disputed individual balance bills by a mediation process modeled after that used in Texas which seems to have worked fairly well. Insurance network adequacy and related issues were also addressed. What will be done with those recommendations is yet to be determined.
Balance billing is also being studied along another tract. The 2016 legislature mandated a task force on balance billing to present recommendations prior to the 2017 legislative session. The task force was initiated in early fall and is being led by Rep. Ron Travis. We have a seat at this table as well. Thus far the task force has consisted of a series of interrogatories to the members seeking to expose a more full understanding of the issues. A formal meeting is pending.
There remains a lot to be settled . Balance billing and insurance network adequacy will be a primary concern for us, other hospital based providers, and the TMA. No one wants the patients to get stuck with unduly large bills when they thought they had insurance coverage.Neither do we want to be put in a position where the insurance carriers dictate what we are paid and no longer find it advantageous to negotiate reasonable contracts with us.
On another subject there were rumors in late summer that there would be legislative efforts to remove the exclusion of radiologists, anesthesiologists, pathologists, and emergency med doctors fro the TN “Corporate Practice of Medicine” laws thus allowing hospitals to directly hire us. To the best of our knowledge these are unsubstantiated. We have been told the TN Hospital Association has no plans for this. We will continue to monitor.
Hope you all have a great holiday season. Will let you know when have more information to share.
Jim Wolfe
Chairman Legislative Comm.
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