The American College of Emergency Physicians is weighing in on a study they say "fails to provide a fair assessment of so-called surprise billing in emergency care."
The study in question was published last November in The New England Journal of Medicine. It ultimately revealed patients receive surprise out-of-network bills for 22 percent of in-network ER visits.
For the study, researchers said they examined billing data covering 2.2 million emergency episodes and tens of millions of people with private insurance.
Rebecca Parker, MD, president of ACEP responded to the study via a letter published in the NEJM. She said the "health insurance industry caused surprise billing by raising deductibles and arbitrarily reducing reimbursement to unacceptable levels for emergency physicians." She also wrote in her letter: "Using an incorrect interpretation of the ACA, the industry takes advantage of emergency medicine's unusual mandate under the Emergency Medical Treatment and Active Labor Act, which requires that 100 percent of emergency patients be seen, regardless of ability to pay."
Additionally, Dr. Parker took aim at the data researchers used, saying the data are "proprietary and unavailable for analysis."
"As soon as we saw the outrageous claim that patients received thousands of dollars in balance bills from emergency physicians we knew we had to respond strongly and quickly," Dr. Parker said in a news release. "It's simply not true. We know that as an industry the balance bills of emergency physicians are less than $200 on average. Our state-based data demonstrates this and sets the record straight."
Researchers defended the study.
"In response to Dr. Parker's criticism that we are not making our data public: 60 percent of individuals get their insurance from a private insurer. To understand what is happening in these private markets, researchers need to use data from private insurers. If an insurer's private data were made public, it would place them at a competitive disadvantage," they wrote in the NEJM.
Read Dr. Parker's full letter and the researchers' full response here.
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