“I knew it was not going to go well, but I didn’t know it was going to be this bad.”
By Petr Borans
Congress Wants to Eliminate IDR. One of Its Original Authors Saw the Problem Coming.
I came across an interview with Congressman Frank Pallone that I found particularly interesting, especially given how much time we’ve spent recently looking at the No Surprises Act and the federal IDR process.
Pallone helped write the original legislation in 2020 and acknowledged that arbitration was a compromise necessary to get it passed. His comment to CBS News was pretty interesting. “I knew it was not going to go well, but I didnt know it was going to be this bad.”
Now he’s introduced legislation to eliminate federal IDR arbitration and move toward a reimbursement methodology based on median in-network contracted rates. I think its a good idea and something worthy of debate.
The No Surprises Act accomplished something important by protecting patients from unexpected medical bills. But the arbitration process has brought unintended administrative costs into a system already struggling with affordability.
Pallones proposal brings forth an interesting question for all of us: Can we make reimbursement more predictable, reduce unnecessary disputes and remove some of that expense without creating new problems for providers?
I think we should be looking seriously at that possibility. And with the amount of clinical, financial and pricing information available today, we have a much better foundation for doing so .Ultimately, the objective should be less money spent arguing over reimbursement and more attention to the cost of healthcare itself.