Health systems, insurers, trade associations, ambulance companies and physician staffing firms are increasing their lobbying efforts to determine how the U.S. will enforce its ban on surprise medical billing, Politico reported April 23.
The No Surprises Act, a measure to end surprise medical bills for emergency and scheduled care, was passed in December when then-President Donald Trump signed a $1.4 trillion year-end spending deal into law. The ban is slated to take effect in January 2022.
Now, President Joe Biden's administration must figure out how to address the ban's unresolved issues, among them the questions of how to prevent patients from unknowingly signing away their protections, how insurers should calculate initial payments to out-of-network providers, how to settle disputes between providers and insurers and how to punish providers who don't cooperate with the ban.
HHS is responsible for answering most of these questions, and healthcare groups have been bolstering their efforts to lobby the department. For example, the American College of Emergency Physicians told Politico their efforts focus on establishing a fair arbitration system for settling payment disputes, and a trade group spokesperson told the outlet insurers are working to ensure regulations prevent bad actors from playing the system to their advantage.