Federal agencies announced Sept. 30 interim final rules for the No Surprise Act. The billing rule has concerned some hospitals and physicians, and now healthcare executives are issuing statements on the act.
The act was signed into law in December 2020 as a measure to end surprise medical billing. Now, agencies have released the next rule in a series of regulations implementing the No Surprises Act. It addresses dispute resolution, good faith cost estimates and external review processes. Several major healthcare organizations and executives have released statements regarding the newly released interim rules.
Here is what four healthcare leaders had to say about the regulations:
American Hospital Association Executive Vice President Stacey Hughes said: "The No Surprises Act was an important step forward in protecting patients from surprise medical bills. Hospitals and health systems strongly support these protections. Today's rule is a windfall for insurers. The rule unfairly favors insurers to the detriment of hospitals and physicians who actually care for patients. These consumer protections need to be implemented in the right way, and this misses the mark."
Federation of American Hospitals President and CEO Chip Kahn issued this statement: "The interim final regulation issued today to implement the No Surprises Act is a total miscue. It inserts a government standard pricing scheme arbitrarily favoring insurers. This regulation discards all of that hard work, misreads Congressional intent, and essentially puts a thumb on the scale benefiting insurers against providers and will over time reduce patient access."
America's Health Insurance Plans President and CEO Matt Eyles said: "The Administration's approach signals a strong commitment to consumer affordability and lower health care spending through an independent dispute resolution process that should encourage more providers to join health plan networks. We are particularly encouraged to see the rules conform to the intent of the No Surprises Act and direct that arbitration awards must begin with a presumption that the appropriate out-of-network reimbursement is the qualified payment amount."
The American Medical Association posted an article Oct. 1, which read, "The AMA has serious concerns about the method for calculating the qualifying payment amount (QPA), a provision of the No Surprises Act." It also cited dispute-resolution fairness and the potential to confuse physicians as other issues with the implementation plan.