As 2019 draws to a close, and despite a flurry of activity throughout the year, the House and Senate have been unable to reach agreement with respect to balance billing. Members of the House and Senate introduced a myriad of bills all targeting “surprise medical billing.” They held hearings and negotiations. They spoke repeatedly about the evils of surprise medical billing and the desire to fix it. However, it is nearly the end of 2019 and legislators still cannot agree on how to handle disputes between the providers and insurers (arbitration or benchmarking), among other key terms of any surprise billing legislation.

At least nine bills were introduced that address surprise medical billing:

     End Surprise Billing Act of 2019 (H.R. 861; Introduced January 30, 2019 by Rep. Doggett [D-TX])

     Protecting Patients from Surprise Medical Bills Act (S. 1266; Introduced May 1, 2019 by Sen. Scott [R-FL])

     Stopping the Outrageous Practice of Surprise Medical Bills Act (S. 1531; Introduced May 16, 2019 by Sen. Cassidy [R-LA])

     Medical Billing Fairness Act of 2019 (S. 1607; Introduced May 22, 2019 by Sen. Kennedy)

     Lower Health Care Costs Act (S. 1895; Introduced on June 19, 2019 by Sen. Alexander [R-TN])

     Protecting People From Surprise Medical Bills Act (H.R. 3502; Introduced June 26, 2019 by Rep. Ruiz [D-CA])

     No Surprises Act (H.R. 3630; Introduced July 9, 2019 by Rep. Pallone [D-NJ])

     Reauthorizing and Extending America’s Community Health Act (H.R. 2328; As Amended July 11, 2019; Introduced by Rep. O’Halleran [D-AZ]) – Includes the text of the No Surprises Act.

     Protecting Patients from Surprise Medical Bills Act (H.R. 4223; Introduced August 30, 2019 by Rep. Spano [R-FL])

Not one of these bills has significantly advanced. Now, two committees – the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee — say they are working on a compromise. That compromise purportedly provides for a median in-network benchmark and arbitration if a bill is more than $750. The compromise also includes protections against surprise medical bills from air ambulances. No bill has been introduced by either the Senate or the House.

Will we see a solution to surprise medical billing in 2020? It will certainly be a hot button issue, but any meaningful resolution is uncertain.