June 24, 2019
Action Alert: Contact Your U.S. Senators and Urge Them to Oppose The Lower Health Care Costs Act Of 2019 (S. 1895)

The CAP is extremely concerned with several provisions in Title 1 of the Lower Health Care Costs Act of 2019, which is designed to address surprise billing. The CAP opposes this legislation as introduced. It has always been the CAP's position that patients should not be financially penalized for the failure of health insurance plans to establish adequate in-network access to hospital-based physician specialties and we have been continuously engaged with Congress on this issue. However, we strongly oppose sections of the legislation the Senate HELP Committee has introduced, as these provisions contain an inequitable benchmark that would enrich health plans. The CAP is disappointed with the exclusion on an arbitration provision to settle disputes. The legislation as drafted will undermine the economic viability of health care delivery and cause significant harm to the pathologists' ability to serve patients, especially in rural areas.  We need all CAP members to urge their senators to remove any benchmark payment that pegs to median in-network rates, and replace it with a payment system that balances insurer and physician rates .

Since Congress started discussions on rectifying this issue last year, the physician community has forcefully and consistently stated that using a payment benchmark tied solely to the median in-network rates is untenable and unacceptable. We cannot accept a payment formula that is unilaterally controlled by insurance companies, who have somehow become absolved from paying for the care they promised to patients. As providers of health care, small businesses, and integral parts of the health care delivery system, it is essential that physicians can contract in good faith, without the federal government concentrating decisive negotiating power in the hands of one party.

For 20 years, Congress fought against the sustainable growth rate formula in the Physician Fee Schedule, warding off drastic cuts to physician payments to help ensure the best physician workforce was available for the American people. We are wondering today why that concern is suddenly gone, and Congress feels insurers should not have to negotiate fairly with doctors across the country.

CSP 72nd Annual Meeting - Save the Date!

December 3 - 7, 2019
Hyatt Regency San Francisco
5 Embarcadero Center, San Francisco, CA 94111


California Society of Pathologists
One Capitol Mall Suite 800
Sacramento, CA 95814 
Tel : 916-446-6001
Fax :  916-444-7462