Medical organizations continue to fight surprise-billing dispute process: 5 details

CALAAEM News Service calaaem.news.service at gmail.com
Thu Jan 13 10:17:15 PST 2022



 

January 11, 2022

 

Medical organizations continue to fight surprise-billing dispute process: 5
details

 

 
<https://www.beckershospitalreview.com/legal-regulatory-issues/medical-organ
izations-continue-to-fight-surprise-billing-dispute-process-5-details.html>
Becker Hospital Review

 

Alia Paavola 

 

A coalition of medical organizations, including the Physicians Advocacy
Institute and 16 state medical associations, filed an amicus brief
supporting a legal challenge to the No Surprises Act dispute resolution
process, according to a news release emailed to Becker's.

 

Five things to know:

 

1. The groups are supporting a lawsuit filed by the American Hospital
Association and American Medical Association.
<https://www.beckershospitalreview.com/legal-regulatory-issues/hospital-phys
ician-groups-sue-feds-over-surprise-billing-provision.html>  The lawsuit
challenges the dispute resolution process outlined in CMS' surprise-billing
rule released Sept. 30. 

 

2. The lawsuit alleges that the independent dispute resolution process,
which requires arbiters to first consider the health plan's median
in-network rate as the appropriate reimbursement amount, unfairly favors
health plans.

 

3. Specifically, the medical organizations that filed the brief Jan. 4 argue
that federal regulators ignored congressional intent of the No Surprises Act
by relying almost exclusively on the median in-network billing rate to
resolve billing disputes instead of considering a multitude of factors.

 

4. "Physicians have an obligation to reinforce for the court just how far
federal regulators walked away from the No Surprises Act's balanced approach
to resolving payment disputes and explain how bypassing the law will
unfairly empower insurers at the expense of patients and their physicians,"
said Dustin Corcoran, president of Physicians Advocacy Institute and CEO of
the California Medical Association, both of which joined the amicus brief.
"If the court allows this damaging example of regulatory overreach to stand,
patients and physicians will pay the price."

 

5. There are 26 physician organizations that joined the amicus brief. Read
the full list of organizations here
<http://www.physiciansadvocacyinstitute.org/Portals/0/assets/docs/Advocacy/P
AI%20Press%20Release%20-%20Amicus%20Supporting%20AMA%20and%20AHA%20-%20Final
%20(1).pdf?ver=geLydZzOWegt9m_EDNZkrw%3D%3D> . 

 

 

 

 

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

 

Contact us at:  <mailto:calaaem.news.service1 at gmail.com>
calaaem.news.service1 at gmail.com

For more articles, visit our
<https://www.aaem.org/get-involved/chapter-divisions/calaaem/news-service>
archives. 

 <mailto:somcaaem at uci.edu> To
<https://maillists.uci.edu/mailman/listinfo/calaaem>  unsubscribe from this
list, visit our mail server.

Copyright (C) 2022. The California Chapter of the American Academy of
Emergency Medicine (CAL/AAEM).  <http://www.calaaem.org/>
http://www.calaaem.org. All rights reserved.

CAL/AAEM, a nonprofit professional organization for emergency physicians,
operates the CAL/AAEM News Service solely as an educational resource for
physicians. Dissemination of an article by CAL/AAEM News Service does not
imply endorsement, agreement, or recommendation by CAL/AAEM News Service,
CAL/AAEM, or AAEM.

 

Follow CAL/AAEM on Facebook and Twitter and check out WestJEM:

 

 <http://www.facebook.com/CALAAEM>       <https://twitter.com/CALAAEM>
<https://westjem.com/> 

 

 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20220113/b53ebedf/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 14160 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20220113/b53ebedf/attachment-0004.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.jpg
Type: image/jpeg
Size: 982 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20220113/b53ebedf/attachment-0005.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image003.jpg
Type: image/jpeg
Size: 919 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20220113/b53ebedf/attachment-0006.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image004.jpg
Type: image/jpeg
Size: 2533 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20220113/b53ebedf/attachment-0007.jpg>


More information about the CALAAEM mailing list