AUSTIN (KXAN) — The “dark money” group Doctor Patient Unity is spending thousands of dollars on television ads this summer urging Texas Senators Cruz and Cornyn to oppose a policy trying to curb surprise medical bills. Congress is expected to take up a series of bills to lessen the financial load on patients when health providers and health insurance can’t agree on who pays what.
Usually “surprise medical bills” happen when an out-of-network doctor sees a patient at a hospital. Many times the patient does not know the doctor is out-of-network but is left with the bill when the insurance company doesn’t cover it. A bipartisan group of lawmakers in the Senate Health, Education, Labor, and Pension committee will debate a bill on whether the government should set rates doctors can charge for out-of-network work.
The idea would set a regional benchmark out-of-network doctors could charge patients as the median charge for a specific procedure. Many insurance companies want it. Most doctor groups oppose the idea, preferring requiring an arbitration process. Both say surprise medical bills should not be left all on the patient.
David Fleeger, MD, President of the Texas Medical Association tells KXAN their group “is adamantly opposed to the current proposal which uses a median in-network reimbursement rate as the de facto rate for out-of-network services, as this allows the health plans to unilaterally and unfairly control payment rates. TMA instead prefers an independent dispute resolution where there is a impartial party that helps determine a fair resolution between physicians and health insurers, similar to what the Texas Legislature enacted this past session.”
While Doctor Patient Unity is pumping in thousands of dollars to TVs across Texas and around the country, the group is not required to tell the public who pays for the ads.
Insurance companies and their representatives say rate setting is a fair way to get the burden off of the patient.
Jamie Dudensing, the CEO at Texas Association of Health Plans tells KXAN, “It’s very disturbing what’s happening,”
“It just shows that there are some providers out there that are so afraid of losing this excessive profit area and the ability to keep price-gouging patients, that they are going to this effort to show these ads and scare the American patient,” said Dudensing.
If the insurance companies are expected to pay more, says Dudensing, people’s premium payments are likely to go up to cover the cost.
According to documents from the Federal Communications Commission, Janna Rutland is the treasurer for Doctor Patient Unity. Her address is listed as a P.O. Box in Birmingham, Alabama. Doctor Patient Unity does not have to disclose who is paying for the ads because they are issue ads and not political ads for or against a certain candidate.
Rutland did not list any contact information on the FCC documents. The group’s website lists a generic contact email. KXAN reached out via email and has not heard back yet.
The group doesn’t have to tell the public who pays for the ad and haven’t, since a Supreme Court decision in the 1970s.
“This is baked into the first amendment of the constitution right, the right to petition the government. That’s what they’re doing right. They’re saying hey we think you should do X or not X,” said University of Texas Professor Brian Roberts, who will teach two classes on money in politics next semester at UT.
Roberts says these issue ads are not new at all. While these ads mention Senators, they don’t campaign for or against a person, so they don’t have to tell the Federal election commission where the money comes from.
You’ll likely see more of these because there are billions of dollars at stakes across the country.
“One would be surprised if there weren’t people intervening and expressing their views about this sort of thing,” said Roberts.
Congress returns to D.C. in September after Labor Day.