Teche Action Clinic treats patients on a sliding fee scale basis, including folks with and without insurance. Our success has led us to grow from our main campus in Franklin, to 13 other sites throughout the state.
However, we cannot solve all the problems facing the patients we treat alone. Some issues must be resolved at the national level, and surprise medical billing is one of them. Patients who recently received medical treatment should not have to worry about excessive, out-of-network costs — they should be focused on their own recovery. Congressional action and legislation is needed to end this unjust practice permanently.
U.S. Sen. Bill Cassidy has been a leader in addressing this issue, and now the U.S. House of Representatives must join him in ensuring a solution. Particularly for rural patients and communities, like those served by Teche, proposals should not create more barriers to care and efforts, like those by Cassidy, have sought to make sure this doesn't happen. benchmarking would have this exact impact.
Benchmarking is one proposal which would allow the federal government to determine rates paid to physicians performing out-of-network care. This approach ignores the drastic differences in the cost and complexity of providing clinical services in different geographical locations and various facility types. Especially for rural hospitals and emergency rooms — which operate on razor-thin margins as it is — a benchmarking approach could be devastating, potentially leading to higher rates of provider consolidation and worsening a doctor shortage that is already impacting patients. As a primary care provider, Teche Action Clinic — and the patients we serve — would be particularly hurt by this approach.
Instead of taking us down this road, Congress should pass legislation that protects patients from surprise medical billing while strengthening patient access and quality of care. Such a solution can be found in legislation that includes Independent Dispute Resolution, rather than benchmarking, as a means by which to eliminate surprise billing. This is the approach supported by Cassidy and which we hope our House leadership can now spearhead.
This process, known as IDR for short, would empower physicians and insurers to negotiate out-of-network payments through a simple, online process overseen by an independent, third-party mediator. Further, until a final decision is reached, providers would receive temporary payments that — especially in the case of rural health care — would help provide financial stability for hospitals and emergency rooms. That, in turn, would ensure access and quality is not jeopardized for any patients.
We hope Minority Whip Steve Scalise would champion the IDR approach as it has been outlined by Cassidy’s STOP Surprise Medical Bills Act because it is the right solution for patients in Louisiana and across the country.
Howard Costay Jr.
board member, Teche Action Clinic