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(HealthNewsDigest.com) – “We agree with the president that patients should not be responsible for coverage gaps and for any costs beyond their in-network cost sharing when they do not have an opportunity to choose an in-network physician. We also agree that physicians and hospitals should be transparent about their costs, and payers should offer transparency about their networks, scope of coverage, and out-of-pocket costs. In addition, insurers should be held accountable for their contributions to the problem and ensure network adequacy, adherence to the prudent layperson standard for emergency care in current law, and reasonable cost-sharing requirements.
“Some of the principles raise more questions than answers, however. For instance, while the idea of a single bill sounds appealing, putting that into practice could have significant unintended consequences.
“Solutions that policymakers adopt must incorporate network adequacy requirements to reduce the likelihood of unanticipated out-of-network care from the start. Policymakers must establish incentives to negotiate fair contracts and build adequate networks.
“The AMA looks forward to working with the Administration and Congress. Our patients deserve a holistic solution that preserves access to affordable, high quality care.”
Editor’s note: Last month, the AMA sent a letter to Congress laying out its vision for addressing surprise billing. Earlier this week, an op-ed by Dr. McAneny on the subject ran in The Hill.