Take Action: Urge Congress to Oppose the Problematic "No Surprises Act" December 18, 2020 California Medical Association, Congress, Legislation, Medicaid, Medical Billing, Medicare, No Surprises Act, Physician Practices 1162 CMA Physicians, Congress will not meet the December 18 deadline to finish the year’s business. Congress will be working over the next several days to finalize the year-end legislation that addresses COVID-19 Relief, Medicare payment, and perhaps surprise medical billing. Most of the health care issues are not yet resolved! THEREFORE, CMA IS ASKING PHYSICIANS TO CONTINUE TO CONTACT YOUR MEMBERS OF CONGRESS. INSERT THE FOLLOWING CMA MESSAGE INTO THE AMA PHYSICIAN GRASSROOTS SAMPLE LETTER. Please use the AMA Grassroots link below. DON’T FORGET THE FRONTLINE CALIFORNIA PHYSICIANS FIGHTING TO SAVE PATIENTS FROM COVID-19! Physicians still need: More COVID Relief in the Provider Relief Fund, more funding for PPE, testing, vaccines and patients. The 2021 Medicare Payment Cuts Stopped (up to 10% cuts to hospital-based physician specialists fighting COVID). Payment cuts mean less patient access to care. A more balanced surprise billing solution (The current one cuts hospital-based physicians specialists fighting COVID by 15-20%.) We need a few final changes to the bill. Please don’t let Congress go home without providing real help to physicians who are working tirelessly to save Californians - at great risk to themselves and their families. See the LA Times article below. “ICU Availability in Southern California at 0%, and it’s going to get worse, officials warn” ”…hospitals flooded by unprecedented numbers of COVID-19 patients” (0% capacity in all of southern California, including the Central Valley; less than 10% capacity in the rest of California) Read in Los Angeles Times: https://apple.news/Ajh8LHgavQ7-IbM1ZVsBrkA Original Message Below: Friday evening, a new bipartisan, bicameral proposal to address surprise medical billing—The No Surprises Act—was introduced and is intended for action before the 116th Congress adjourns in a few days. The California Medical Association (CMA) is urging physicians to contact their members of Congress now and tell them to stand up for patients and physicians by opposing the bad provisions in the No Surprises Act. Background CMA worked closely with the committees and leadership offices to achieve improvements to the “No Surprises Act.” Despite these CMA-supported improvements, CMA continues to have serious concerns with two poison pills that were included in the legislation, which undo any real progress made in other parts of the legislation to incentivize insurers to contract and ensure a balanced dispute resolution process. 1. Medicare and Medicaid rates can be included in the dispute resolution process. CMA is strongly urging Congress to only allow rates paid in the commercial market to be considered in the dispute resolution process. This provision is blatantly unfair and will heavily influence private market rates for in-network services. CMA is extremely concerned that it will lead to reduced private sector payment rates at a time when physician practices are already struggling with the impact of the COVID-19 pandemic. 2. The 90-day “cooling-off period” creates an unfair hurdle to resolving disputes. Small- and medium-sized physician practices operate on thin margins and cannot wait more than five months to get paid. If an insurer can wait 165 to pay the full claims and have Medicare and Medicaid rates as payment factors, there is little incentive for insurers to contract with physicians upfront. Now is not the time to adopt flawed surprise billing legislation. Please contact your members of Congress now and tell them to stand up for patients and physicians by opposing the bad provisions in the No Surprises Act!