American Society of Anesthesiologists Welcomes Improvements to No Surprises Act IDR Process

CHICAGO — The American Society of Anesthesiologists (ASA) commends the Centers for Medicare & Medicaid Services (CMS) for taking positive steps towards returning balance to the independent dispute resolution (IDR) process of the No Surprises Act (NSA) through a recently proposed rule. The changes would include the creation of an IDR registry, mandatory requirements that health plans use remittance advice remark codes (RARCs), and improvements to the Open Negotiations period. 

ASA’s formal February 1 letter to the U.S. Departments of Health and Human Services, Labor and Treasury (the Departments) expresses strong support for many of the proposed changes and provides further recommendations for needed improvement to the NSA process. The Departments deadline for comments is February 5. ASA’s additional suggestions include expanding the batching process to align with real-world contracting practices, optimizing batch size and creating enforcement mechanisms for recalcitrant payers who delay or deny appropriate payments to physicians who have prevailed in the IDR process.  

“ASA applauds the Departments for their efforts to improve the IDR process. Many of the provisions in the proposed rule include important solutions to challenges physicians face as they navigate the process,” said ASA President Ronald L. Harter, M.D., FASA. “We appreciate that several of our past comments and suggestions have been incorporated into the rulemaking, and request that the Departments consider our additional recommendations.”

ASA has always supported the No Surprises Act’s efforts to safeguard patients, but the flawed initial implementation of the law created serious problems for anesthesiologists and other health care professionals and permitted a gaming of the IDR process by payers. Problems include unreasonably low payer-calculated qualifying payment amounts, lack of a meaningful participation by payers in the negotiation period, and the lack of IDR process transparency. 

“Continued improvement of the IDR process is critical for physicians, who are on the front lines of patient care. We are confident that these further improvements will begin to help address common problems anesthesiologists and other physicians are experiencing through the IDR process,” said Dr. Harter.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research, and scientific professional society with more than 57,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/MadeforThisMoment. Like ASA on Facebook and follow ASALifeline on Twitter.

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