Monitor Mondays

No Surprise: Stakeholders Fight to Solve Surprise Billing

June 03, 2019
Monitor Mondays
No Surprise: Stakeholders Fight to Solve Surprise Billing
Chapters
Monitor Mondays
No Surprise: Stakeholders Fight to Solve Surprise Billing
Jun 03, 2019
Chuck Buck | Ronald Hirsch, MD | Knicole Emanuel Esq. | David Glaser, Esq. | Mary Inman, Esq. | Ellen Fink-Samnick | Matthew Albright
The fight is on, and combatants are sparring over how to implement a legislative ban on surprise balance billing.
Show Notes

The fight is on, and combatants are sparring over how to implement a legislative ban on surprise balance billing. 

In recent congressional testimony, providers, payers, and hospitals have clashed on how to keep patients from being stuck with huge expenses, with each side blaming the other for being intransigent. One of the major issues is how out-of-network doctors should be reimbursed, and at what rate. 

Reporting our lead story during this edition of Monitor Mondays will be Matthew Albright, chief legislative affairs officer for Zelis and the former Director of the Administrative Simplification Group of the Centers for Medicare & Medicaid Services (CMS).

Other segments to appear on the broadcast include:

  • RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group. Emanuel begins this broadcast as a permanent Monitor Mondays panelist.

  • Court Report: Intermountain Healthcare recently settled a high-profile case alleging unnecessary heart procedures. On hand to explain the significance of this case is famed whistleblower Mary Inman, a partner in the London office of Constantine Cannon.

  • SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SdoH), returns to the broadcast as a permanent panelist. And in this edition of Monitor Mondays, she will explain why so many consultants appear to be jumping on the SDoH bandwagon – and why this could be problematic.

  • Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment. 


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