CAHC Cheers House Subcommittee Action on Real-Time Benefit Tools, Surprise Billing

Coalition racks up advocacy wins in House Energy and Commerce Health Subcommittee markup of 10 healthcare bills

WASHINGTON, DC (July 11, 2019): The Council for Affordable Health Coverage (CAHC) – a coalition of employers, insurers, life science companies, PBMs, brokers, agents, patient groups, and physician organizations – praised the bipartisan showing of support for real-time benefit tools (RTBTs) and solutions to surprise billing in today's House Energy and Commerce Health Subcommittee markup of 10 bills.

"With today's subcommittee markup, lawmakers took bipartisan action on a slate of CAHC priorities that will make a meaningful difference in the lives and pocketbooks of patients and their families," said CAHC President Joel White. "CAHC members know that real-time benefit tools hold great promise to finally give patients actionable drug pricing information at the point of prescribing - helping them to avoid sticker shock at the pharmacy, remain adherent to prescribed therapies and, if necessary, have a conversation with their provider about alternative, more affordable treatment options."

White continued, "Similarly, we have been unrelenting in our work to press Congress on answers to surprise medical bills - holding Congressional briefings, sending letters to lawmakers, and offering preliminary scoring of various surprise billing proposals. The bill advanced by the subcommittee today wisely tackles this challenge without resorting to harmful binding arbitration policies that could make a bad problem worse. We thank Chairwoman Eshoo (D-CA), Ranking Member Burgess (R-TX), and members of the subcommittee for their leadership on these issues. We look forward to swift action by the full committee."


Following CAHC's unveiling of its "Prescriptions for Savings" campaign earlier this year, which emphasized expanding RTBTs, the committee today unanimously adopted an amendment in the nature of a substitute to HR 2296, the FAIR Drug Pricing Act of 2019, with these provisions included (Section 7). CAHC is working with committee members and staff on technical changes to further strengthen the bill ahead of a full committee markup.

CAHC has also championed measures to lift the threat of surprise billing without resorting to so-called "independent dispute resolution" or "binding arbitration" policies that, which CAHC has previously warned, "would be the IPAB of hospital billing and an administrative nightmare for all involved." Most recently, CAHC President Joel White joined more than two-dozen health policy experts on a joint statement opposing binding arbitration as a resolution to surprise billing disputes.

The subcommittee acted today by unanimously passing H.R. 3630, the No Surprises Act, which rejects binding arbitration by establishing a payment benchmark based on median contracted rates in the same geographic region to resolve out-of-network payment disputes.