Federal Health Policy Committee (FHPC)
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Review Model Legislation Before Monday’s FHCP Meeting
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Review Model Legislation Before Monday’s FHCP Meeting
Federal Health Policy Committee,
In preparation for next week’s FHPC meeting, we ask you to review the attached model legislation that shifts the collection of patient cost share to insurers. We need your input to ensure EDPMA’s position reflects the will of our membership.
Background and Context
Led by Dr. Bing Pao, EDPMA formed a task force to address uncompensated care and bad debt from patient cost share collection.Dr. Pao co-authored an article published in the Journal of Emergency Medicine (attached) that states that emergency physicians collect about half of the patient cost share in California.
In other states, the percentage of cost share collected is much lower. Many other physicians struggle with collecting patient deductibles. While patients are responsible for the cost share, providers are not obligated to collect the cost share unless the provider is contracted to do so. Physicians also absorb a significant cost associated with collecting the patient cost share. Requiring health plans to collect the patient-share of cost will reduce administrative costs associated with collections and simplify the billing process for patients.
Over the years, resolutions have been introduced at various medical societies advocating for health plans to collect the patient cost share. The California Medical Association adopted a resolution in 2017. In 2021, Senator Pan introduced SB 250 in the California Senate. And, the California Medical Association lobbied for the passage of the bill. The bill passed the Senate but was held in the Assembly Health Committee. The Chair of the Assembly Health Committee had concerns with how the patient cost share would be collected by managed care groups. A similar resolution that was adopted by the ACEP Council in 2018. In November, the AMA drafted a report and adopted policy to advocate for having the health plans collect the patient cost share.
Physicians should not be the bill collector for the health plans. Bloomberg posted an article, “Doctors are Fed UP with Being Turned into Debt Collectors” that report on physician frustration with collecting patient debt.
The administrative and financial burden takes time and resources away from patients.
What We Need From You
We will discuss this issue and EDPMA’s proposed position during Monday’s Federal Health Policy Committee meeting. In the meantime, please review these materials and be prepared to indicate:
- You
agree with EDPMA’s drafted position - You
do not agree with EDPMA’s drafted position - You
have concerns on the drafted position
If you have concerns, we welcome your feedback prior and during the meeting.
Next Steps
We will facilitate a similar exercise during the next State Regulatory and Insurance Committee (SRIC) meeting. EDPMA leaders will share the feedback from both the FHPC and SRIC communities with the Board of Directors who will make the final determination of EDPMA’s position.
Thank you in advance for reviewing these materials so that our upcoming discussion is focused and productive.
- You
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