TMA Working Toward Balance Billing Solution in 2020

November 6, 2019

Despite a summer surge of Congressional activity on surprise medical billing, momentum appears to have stalled on multiple bills to address it in Washington, DC, and TMA is renewing its focus on spearheading a proposed solution for the Tennessee General Assembly to consider when it reconvenes in January 2020.

TMA has been engaged in federal advocacy and public relations efforts since June as Congress considered different proposals regarding balance billing. Tennessee physicians interacted directly with federal lawmakers and penned op-eds in media outlets across the state. At least three bills were moving through the committee process in recent weeks, and doctors were vocal in opposing measures that would amount to rate setting, more leverage for insurance companies and more heavy-handed government interference in the delivery of care.

Meanwhile, the TMA Board of Trustees approved the Legislative Committee’s recommendation to make balance billing a top legislative priority in 2020. TMA’s goal heading into the upcoming session is to reach a solution at the state level that frees patients from the financial burden of unexpected out-of-network charges while protecting physicians’ rights to choose how they practice and get paid appropriately for services they provide.

TMA will work with state lawmakers to support legislation that represents its core principles on balance billing:

  • Hold patients harmless for out-of-network charges without removing Tennessee's ban on the corporate practice of medicine, prohibiting balance billing or obstructing physicians' right to be fairly compensated for the services they provide.
  • Do not allow insurance companies to set their own reimbursement rates without negotiating with physicians and other healthcare providers.
  • Create a fair arbitration process to resolve payment disputes between providers and payers, and keep the patient out of it.


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