Protect Tennesseans’ emergency medical care, not insurers’ profits

The ban on surprises is to be implemented in order to secure patient care and the livelihood of the emergency doctors.

Dr. James Parnell
| Guest columnist

Doctor grants insight into NYC emergency room

Doctor grants insight into NYC emergency room

AP

• Dr. James Parnell is an emergency physician in Gallatin, Tennessee and president of the Tennessee Chapter of the American Academy of Emergency Medicine.

As an emergency physician, I have seen firsthand how unexpected medical bills can put patients in financial instability and weaken doctors’ ability to provide world-class medical care. Patients admitted to the emergency room after a car accident or heart attack often have no choice over whether to be treated by a doctor who is part of their insurance network. Fortunately, Congress passed the bipartisan No Surprises Act last year to protect patients from unexpected, no-fault medical bills and to ensure doctors receive the appropriate reimbursement that we depend on for care.

What does the No Surprises Act do?

The No Surprises Act introduced an independent dispute settlement process that enables insurers and providers such as doctors and hospitals to resolve billing disputes in a fair and equitable manner. States like New York and Texas have similar laws in place proving that this system will help patients and create a level playing field between doctors and health insurers.

However, the insurance industry is still trying to maximize profit at the expense of doctors and our patients. Health insurance companies are trying to weaken the law with the help of the rule-making process and increase their already record-breaking profits. If the Department of Health manipulates the IDR process in favor of major health insurers, frontline providers will face additional and immense financial pressures that could easily destroy America’s medical safety net: its emergency rooms and their staff.

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Emergency rooms, employees form a precarious medical safety net

The COVID-19 pandemic has underscored the important role of emergency doctors in providing life-saving medical care and demonstrated how fragile our medical safety net really is. This would be a devastating time to give major health insurers even more leverage over the front line doctors and their patients. In the midst of the pandemic, insurance companies spent millions lobbying Congress to pass a tariff-setting bill that would allow insurers to impose a 20% pay cut on frontline doctors, according to the Congressional Budget Office. Although major insurers were unsuccessful last year, they are now pushing to influence the rulemaking process to reverse that defeat and protect their profits.

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If insurers succeed, rural hospitals and hospitals in Tennessee and across the country would be at risk. Pricing would have devastating effects on Tennessee medical care, creating a shortage of doctors and adding to the strain on 19 of the 28 rural Tennessee hospitals that are already at high risk of closure. Giving health insurers more power to cut the payments that doctors and hospitals rely on will only accelerate the shutdown of the rural hospitals that millions of Americans rely on.

Tennessee residents’ access to critical medical care is already at risk. Since the pandemic began, Tennessee has lost more than 17,000 healthcare jobs. Although the pandemic is subsiding, patient numbers in Tennessee and across the country remain below average. Even so, more than 2,200 of my colleagues still work in the Tennessee rural emergency rooms. Each of these emergency rooms serves an average of 13,000 patients per year. These patients cannot afford any more hospital closings.

Pandemic life-saving care deserves fair compensation

Now is the worst time to continue hurting our heroic frontline providers as we grapple with the damage caused by the pandemic. Doctors, nurses and other health care providers risked their lives during the pandemic. Policy makers should ensure that they are adequately remunerated for the basic and life saving care they provide.

It is critical that HHS go through the full rulemaking process and allow all stakeholders concerned to express their views on this consistent policy. Rural communities are at risk of losing their hospitals to additional financial pressures. Every patient, regardless of where they live or their ability to pay, deserves high quality and affordable care. I urge U.S. Sens. Marsha Blackburn and Bill Hagerty to work with HHS to ensure patient care and doctors livelihoods by implementing the bipartisan No Surprises Act as intended – to protect patients, frontline doctors and hospitals and not the voracious health insurance industry.

Dr. James Parnell is an emergency physician in Gallatin, Tennessee and president of the Tennessee Chapter of the American Academy of Emergency Medicine.

source https://dailyhealthynews.ca/protect-tennesseans-emergency-medical-care-not-insurers-profits/