Lower Premiums, Faster Payments Act

This bill amends surprise medical billing rules for private health insurance by eliminating the independent dispute resolution process for out-of-network bills starting in 2028 and changing how the base payment rate (qualifying payment amount) is calculated. It also updates payment timelines and audit requirements.

Sec. 2, Adjusting surprise medical billing requirements: For items and services furnished before January 1, 2028, the existing independent dispute resolution process and payment timelines remain in place. For items and services furnished on or after January 1, 2028, the out-of-network rate is set to the qualifying payment amount, and the independent dispute resolution process is eliminated. Payment deadlines are shortened to 30 days after the bill is transmitted when the rate is the qualifying payment amount.

Sec. 2, Adjusting calculation of qualifying payment amount: For 2028, the qualifying payment amount is based on the median contracted rate as of January 31, 2019, adjusted for inflation through 2027. For 2029 and later, it is the previous year's amount increased by inflation. For plans not offered in 2019, a special methodology applies. The Secretary must update rules within 180 days of enactment to implement these changes, and the methodology is not subject to judicial review.

Sec. 2, Annual audits: The Secretary must conduct annual audits of qualifying payment amounts for 2028 and each subsequent year using a sample of at least 25 plans or issuers, and beginning in 2028, the audit findings must be made publicly available.