News | Population Health | December 11, 2019

The American College of Radiology says vital improvements are needed

he “surprise billing” plan unveiled recently by Senator Lamar Alexander (R-TN), Representatives Frank Pallone (D-NJ), and Greg Walden (R-OR), must be improved to gain American College of Radiology (ACR) support

Image by PublicDomainPictures from Pixabay 


December 11, 2019 — The “surprise billing” plan unveiled recently by Senator Lamar Alexander (R-TN), Representatives Frank Pallone (D-NJ), and Greg Walden (R-OR), must be improved to gain American College of Radiology (ACR) support. 

Narrow insurance networks are the cause of surprise medical bills. Patients should only be responsible for in-network cost-sharing when they unknowingly receive out-of-network care at in-network facilities. New legislation to protect patients from surprise medical bills must also guard against unintended impacts on access to care.

Government Rate Setting

The recently announced plan includes government rate setting that would allow insurers to shift more costs to patients via higher deductibles and other cost-sharing. These government price controls would set arbitrary and artificial price points that benefit insurers while restricting the number of providers who can afford to offer such services. There is also no assurance in the legislation that any “savings” to insurers gained from the bill would be passed on to patients — only insurers benefit from this provision.        

Independent Dispute Resolution

The plan also does not include an adequate independent dispute resolution (IDR) provision. The proposed threshold of $750 below which dispute resolution would not occur excludes many of the most common medical services and procedures. This would force medical providers to accept a median in-network payment that would likely be driven progressively lower by insurers to the point that many providers might not be able to continue to provide such services in their communities.

“The American College of Radiology (ACR) agrees that the patient should be protected from ‘surprise medical bills’ resulting from inadequate coverage networks. That is not at question. However, placing unfettered power in these occurrences in the hands of insurers would impact access to care that neither patients, providers or the government will be happy with,” said William T. Thorwarth, M.D., FACR, chief executive officer of the American College of Radiology.

For more information: www.acr.org

Related content:

 


Related Content

News | Clinical Trials

June 27, 2024 — Prenuvo, which makes whole-body MRI screening for early cancer detection and other diseases, has ...

Time June 27, 2024
arrow
News | Lung Imaging

June 18, 2024 — A new study led by American Cancer Society (ACS) researchers shows less than one-in-five eligible ...

Time June 18, 2024
arrow
Feature | HIMSS | Christine Book

February 26, 2024 — This year’s Healthcare Information and Management Systems Society HIMSS Global Conference and ...

Time February 23, 2024
arrow
Feature | Population Health | Christine Book

January 18, 2024 — World Cancer Day, a global initiative led by the Union for International Cancer Control (UICC), will ...

Time January 18, 2024
arrow
Feature | RSNA | Christine Book

November 29, 2023 — Following the theme of the Radiological Society of North America Scientific Assembly and Annual ...

Time November 29, 2023
arrow
News | Lung Imaging

November 22, 2023 — Lung cancer survival rates are improving for everyone, including people of color, according to the ...

Time November 21, 2023
arrow
News | Lung Imaging

November 10, 2023 — As the imaging community recognizes Lung Cancer Awareness Month in November, and Nov. 11 marks ...

Time November 10, 2023
arrow
News | Artificial Intelligence

November 10, 2023 — Emory University has announced that it will be launching a new AI-focused initiative which it ...

Time November 09, 2023
arrow
Feature | RSNA | Christine Book

November 29, 2022 — It was only fitting that on Giving Tuesday, the RSNA 2022 5k Fun Run kicked off the third day of the ...

Time November 29, 2022
arrow
News | Coronavirus (COVID-19)

January 8, 2021 — The U.S. Food and Drug Administration is alerting clinical laboratory staff and healthcare providers ...

Time January 08, 2021
arrow
Subscribe Now