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Committee advances amendment to health bill addressing site-neutral payments, transparency and prior-authorization disputes

5839216 · February 4, 2025
AI-Generated Content: All content on this page was generated by AI to highlight key points from the meeting. For complete details and context, we recommend watching the full video. so we can fix them.

Summary

Representative Barrett presented an amendment broadening a health-insurance bill known in committee as "10 o 3," adding provisions on site-neutral payments, reporting for prior-authorization disputes and other transparency measures; the committee voted to report the bill as amended, 7-3.

Representative Barrett presented an 18-page amendment to the bill described in the hearing as "10 o 3," saying it addresses a range of health-insurance topics and still requires further work. "This amendment does, gosh, 12 to 15 things," Barrett said, summarizing changes that include a clearer definition for a Medicare fraud unit, a reportable standard for prior-authorization disputes, carve-outs for some small grant recipients in a 340B-like provision, a delayed effective date for that provision to 2027 and language allowing a reasonable markup on certain sales.

Barrett identified site-of-service payment rules as the largest area of change. He said the amendment tries to avoid a confusing rulemaking…

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