Congress to include 'surprise' billing fix in spending package

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Congress is set to include a long-elusive ban on “surprise” medical bills as part of the $1.4 trillion year-end spending agreement lawmakers are expected to detail Sunday evening.

Sen. Bill Cassidy (R-La.) told the Capitol Hill press pool Sunday afternoon that the provision was included in the spending bill, and a senior GOP aide confirmed.

Though key congressional committees had agreed more than a week ago on a plan for protecting patients from large medical bills when they unwittingly receive out-of-network care, it had been unclear whether it would be part of must-pass government funding legislation. The final decision came down to Senate Majority Leader Mitch McConnell, who had been silent on the deal.

The White House has already endorsed the plan nearly two years after President Donald Trump first called on Congress to fix an issue that has drawn bipartisan concern. But it was nearly derailed by well-funded opposition groups and congressional turf battles.

What’s new: The details of the provision haven’t yet been released, but Cassidy said it’s “99 percent similar” to a compromise brokered last week by the key health care committees. That deal called for health insurers and providers to negotiate most billing disputes or bring their complaints to a mediator.

The text of the deal is slated to come ahead of an expected vote Sunday night.

Why it matters: Pressure intensified on Congress to advance surprise billing protections in recent weeks, after two years of lobbying from powerful interest groups and policy fights stalled what was originally supposed to be an easy fix for this Congress.

The effort looked all but dead earlier this month, after another round of talks failed to bring House Ways and Means Committee Chair Richard Neal (D-Mass.) on board with a proposal other congressional committees had agreed on last year. But talks resumed again after House Speaker Nancy Pelosi redoubled efforts to get Neal’s support.

For those supporting the surprise billing ban, the must-pass omnibus represents the last obvious opportunity to advance the legislation. Two of the key Republican champions of a surprise billing fix — Senate HELP Committee Chair Lamar Alexander of Tennessee and House Energy and Commerce ranking member Greg Walden of Oregon — are retiring this year.

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