ASA and NSA Partners Urge Enforcement of TMA III Ruling on Ghost Rates
Today, ASA along with its No Surprises Act (NSA) advocacy partners, the American College of Emergency Physicians and the American College of Radiology, urged the federal departments responsible for the NSA to issue “enforcement guidance” to fully implement the elements of the most recent Texas Medical Association (TMA III) court ruling. The TMA III ruling affirmed the prohibition on certain ghost rates in the calculation of qualifying payment amount (QPA). ASA, ACEP and ACR requested that the Departments instruct plans to recalculate any QPAs that include non-eligible ghost rates. To ensure compliance, the Departments must also develop and implement enforcement mechanisms, including new audits and penalties. See the letter here.