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Who’s Behind the Millions Spent on Ads Opposing ‘Surprise Billing’ Law?

“I’m focused on protecting patients from surprise billing, period,” Mr. Walden said in a statement. If hospitals, doctors and insurers mean what they say — that patients should be held harmless and should not face unexpected, exorbitant medical bills — then we need to act with legislation.”

Together, Envision and TeamHealth employ tens of thousands of physicians, most clustered in the kinds of hospital-based specialties — like emergency medicine, radiology and anesthesiology — that can generate large surprise bills.

Envision and TeamHealth sometimes kept their emergency room doctors out of insurance networks when they entered new markets, according to research from a team of Yale economists published in 2017. The researchers found that was more common for Envision practices. Envision, then a public company, vowed to increase the share of its doctors who accepted insurance. But its contracting practices have become less clear since its acquisition by KKR last year.

This summer, Fitch Ratings put the debt of both companies at the top of its list of “loans of concern,” noting that the companies have been “pressured by uncertainty over the outcome of political efforts to cut medical bills.”

“Private equity companies have the most to lose from prohibiting surprise billing, so it’s no surprise that they’d be fighting the hardest to blow up the process,” said Loren Adler, an associate director of the U.S.C.-Brookings Schaeffer Initiative for Health Policy, in an email. Mr. Adler, who has studied the issue, endorses the approach Congress is considering.

Despite its extensive spending, Doctor Patient Unity has a light digital presence. Its Twitter account is followed by only 229 accounts, many held by health care reporters. Among its followers in politics and medicine are the accounts for Envision Radiologists; Glenn Kaplan, the vice president for Radiology Strategy at Envision; Kim Warth, a former Envision spokeswoman. The group’s website is at an address previously used by the advocacy division of Consumer Reports to argue for the passage of surprise billing legislation in states.

Doctor Patient Unity is not the only physician group trying to influence the surprise billing legislation in Congress. Physicians for Fair Coverage has also begun a digital ad campaign and has spent an estimated $240,000 on conventional lobbying this year, according to the Center for Responsive Politics. That physicians group lists its members on its website, and its staff speaks with journalists about the group’s perspective. (Some of its members also have private equity ties.)

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