AAEM Advocacy Alert: Take Action on Surprise Billing

CALAAEM News Service calaaem.news.service at gmail.com
Sat Oct 9 12:38:54 PDT 2021




AAEM is alarmed that the Departments of Health and Human Services, Labor,
and Treasury have chosen to move forward with a regulation published on
September 30, 2021 which disregards the careful balance that Congress struck
when enacting this historic legislation to protect patients from surprise
medical bills. The regulation ignores both the language of the No Surprises
Act and the clear intent of Congress in crafting the law.


In 2020, Congress passed the No Surprises Act to protect patients from high,
out-of network balanced or "surprise" bills. The interim final rule for
implementation of the No Surprises Act published September 30, 2021
instructs arbitrators to use a median contracted rate (QPA) to resolve
disputes between insurers and physicians/hospitals. The original bill
appropriately provided for an IDR process that would not disproportionately
weigh any single factor in determining the payment amount, allowing for the
unique circumstances of each dispute to be measured by a neutral arbitrator.
Legislators also sought to create a process that could be navigated by small
independent physician groups that lack the resources to pursue complex

A fair IDR will give physicians and smaller groups a real opportunity to
resolve payment disputes with large insurance companies in a way that does
not negatively impact these smaller groups. 
Click the button below to
ib0dnpKCRJtKOBIiPGjNjA~~> write an urgent message to your representatives
urging the Departments to revisit this interim final rule and replace it
with a solution that better reflects a balanced, case-by-case approach to
dispute resolution that allows the IDR arbitrator to factor in a variety of
important information, as provided for in the legislation and intended by

ib0dnpKCRJtKOBIiPGjNjA~~> Act Now





Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service


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