Some health care industry groups are pushing back on President Joe Biden’s plan to shield patients from surprise medical bills.
The law is set to take effect in January.
“Hospitals and health systems are therefore profoundly concerned about the decision by the departments to distort the No Surprises Act [independent dispute resolution] process in favor of plans and issuers, at the expense of patients and providers,” Stacey Hughes, American Hospital Association (AHA) executive vice president, wrote in a comment letter, according to Roll Call.
AHA also suggested that the government should be able to retain the rule as written. According to the AHA, it would help control costs for patients, as well as encourage payers and providers to reach a payment agreement before using the independent dispute resolution process.
“By directing arbiters to presume that the plan’s or issuer’s median contracted rate is the appropriate out-of-network reimbursement rate and creating a significantly higher bar for consideration of other factors means that the IDR (informal dispute resolution) process effectively will be unavailing for providers,” Hughes added.
American Medical Group Association (AMGA) President Jerry Penso stated that his group agreed with the lawmakers who believe that the arbiter should consider more factors during the arbitration process, the Roll Call reported.
