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Last week, a bipartisan group of over 150 members in the House of Representatives sent a formal communication to Biden Administration officials urging the interim final rule (IFR) released on September 30 be amended to align the law with the intent of the Congressional legislation.
The actual text of the No Surprises Act law as passed by Congress creates a fair independent dispute resolution (IDR) process under which physicians have an opportunity to secure a reasonable payment. Parameters of the IDR process in the recently released IFR, however, do not reflect the way the law was written. Rather, the rule designed an IDR process that heavily favors health insurance companies in payment disputes by directing the arbiter to give the highest priority to the insurer-calculated median in-network amount over other considerations and arguments presented by physicians.
The letter - led by Rep. Thomas Suozzi (D-NY-3), Rep. Brad Wenstrup, DPM (R-OH-2), Rep. Raul Ruiz, MD (D-CA-36) and Rep. Larry Bucshon, MD (R-IN-8) - was sent to Secretary of Health and Human Services Xavier Becerra, Secretary of the Treasury Janet Yellen, and Secretary of Labor Marty Walsh, who are responsible for federal rulemaking to implement the legislation’s provisions guiding payment disputes between physicians and insurance companies. The letter urges revision of the IFR by specifying that the certified IDR entity should not default to the median in-network rate and should instead equally consider information and arguments presented by physicians.
ASA-member grassroots activists generated over 1,500 messages to the Hill and played a key role in securing many of the Congressional signatories calling for the successful and fair implementation of the No Surprises Act.
ASA continues to work tirelessly with Congress and the Biden Administration to ensure that the No Surprises Act is implemented in a manner consistent with Congressional intent.
