The FEHBlog is safely ensconced within the Capital Beltway again after a weekend in New York City. Congress will be in session on Capitol Hill this week before a long break.  On Tuesday July 12, at 2 pm, the House Oversight and Government Reform Committee will mark up several bills, including its bipartisan Postal reform bill.

Last week, The Centers for Medicare and Medicaid Services proposed a host of 2017 changes to its rules for Medicare Part B payments to doctors and its rules for its outpatient hospital prospective payment system (“OPPS”). “CMS estimates that the updates in the proposed rule would increase OPPS payments by 1.6 percent and [ambulatory surgical center] payments by 1.2 percent in 2017.”

The Wall Street Journal reports that “surprise” medical bills create battles between providers and insurers.  This problem arises when doctors who work in insurer network hospitals, such as emergency room doctors, anesthesiogists, pathologists, etc., are out of network.  The Journal’s lead places blame on narrow insurer networks. But the FEHBlog is aware that this problem exists in all types of insurer networks.  Hospitals should be making a better effort to bring all of their doctors into the insurer networks in which they participate.