The American Medical Association has weighed in on S-1285/A-1952, otherwise known as the physician price-fixing legislation.
In their letter, the AMA writes that it “supports holding patients harmless when they receive unanticipated out-of-network care, but such a hold harmless policy should be accompanied by strong network adequacy protections and a fair level of out-of-network coverage based on charges from an independent data source. A ban on balance billing without the other prongs can have a detrimental impact on the market and access to care.”
“S-l285 and A-1952 would force physicians to accept any contract terms offered by an insurer, fair or not, in order to practice at a hospital, and for hospital-based physicians, there is simply no alternative.”
“Moreover, by capping physician payments at a percentage of Medicare or insurer-determined rates when a contract is not in place, physicians come to the negotiating table, if even invited, without any negotiating tools.”
“This is antithetical to the way contract negotiations traditionally function, as insurers are incented to contract with physicians to receive discounted rates and physicians receive volume, prompt pay, and other inducements. These bills make an already tilted playing field even more unfair for physicians.”