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Surprise billing solution is likely to come out of the next Covid-19 package as the battle for tests ends

A senior Democratic assistant said the House Democrats have been trying to patch in the past month differences between parties on how to protect patients from sometimes faltering costs outside the network – usually from specialist or emergency doctors. But potential friction points remain, and Democrats say the majority of the Senate leader, Mitch McConnell, is against reform reform. McConnell’s office declined to comment.

The White House also has made a proposal to simply ban surprise billing and leave it to health plans and suppliers to negotiate a solution. But physician groups that have significant influence in Congress believe the plan would give insurers too much influence. Private equity-backed physicians-temp agencies helped tank leaders billing reforms last year from House Energy and Commerce and Senate HELP leaders after an intense lobby and advertising blitz.

Lobbyists and patient advocates who support a billing fix still hope McConnell will give in, noting the White House involvement and the issue being a priority of his friend Lamar Alexander (R-Tenn.), The chairman from the HELP committee, which will retire this year.

“Every honest person in this city knows it’s the last train to leave the station and if billing isn’t done in the next three weeks, Congress has given up and abandoned patients across the country,” said James Gelfand , a lobbyist for the ERISA Industry Committee representing major employers.

In addition to McConnell, another major legislator who has yet to show his cards during the pandemic, House Ways and Means president Richard Neal (D-Mass.) Has pushed for a more doctor and hospital-friendly proposal that supports the Energy and Trade and HELP Commission plan say would drive up prices and then insurance premiums.

Neal, a 30-year veteran of Congress, faces a tough primary challenge from progressive Alex Morse, the mayor of Holyoke, Massachusetts, who has been demonstrating the issue since Neal weighed and prevented Congress from pursuing reforms late last year. to feed. A new forward-thinking group called Fight Corporate Monopolies spends $ 300,000 on ads to portray Neal as a prisoner of private equity interests benefiting from surprising medical bills.

Health experts believe that legislators will eventually be wary of crossing hospitals and doctors during a pandemic that will take a significant toll on their finances and bring the matter to next year.

Senate Republicans want to invest more money in Covid-19 tests – although White House opposes the field to add an additional $ 25 billion, say the CDC still has unspent funds from previous aid packages. Democrats blaming the move is another attempt by the government to hide high marks across the country.

The government relied on private insurance to fund most of the country’s tests. But as the supply shortage grows and test lead times lag behind, the Trump administration turns private health plans off the hook by paying for back-to-work or public health surveillance diagnostics, without announcing an alternative funding strategy.

Health plans urge Congress to fill the gap with government funding. But the administration says nearly $ 13 billion of the last $ 25 billion allocated for testing has not yet been spent. A senior official also said that states, municipalities, and tribes spent less than $ 100 million of the $ 10 billion they received from the FBI.

Meanwhile, public health groups say health departments across the country need more resources as cases increase in almost every state.

“The stakeholder community is 100 percent against this kind of thinking,” said Adriane Casalotti, head of government and public affairs for the National Association of County and City Health Officials. “We are in the long term in this pandemic. All levels of the government’s response to public health need more investment. ”

The GOP rescue package is also not expected to address a number of other costly and painful health issues: increased funding for Medicaid or private insurance subsidies for new unemployed Americans who have lost their workplace health plans.

Congressional Democrats and governors have pushed for a fresh increase in the federal portion of Medicaid spending after Congress gave the states a temporary 6 percent increase in March. States struggling with budget deficits warn that they should cut benefits without more federal aid,

Brianna Ehley contributed to this report.