AHA urges agencies to revise surprise medical billing rule

AHA today strongly urged the departments of Health and Human Services, Labor and Treasury and Office of Personnel Management to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations.  
 
Hospitals and health systems are “profoundly concerned about the decision by the departments to distort the No Surprises Act IDR process in favor of plans and issuers at the expense of patients and providers,” AHA wrote. “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 process effectively will be unavailing for providers.” 

AHA also urged the agencies to make the IDR process more efficient and flexible in the batching of claims; align the hospital price transparency rule and good faith estimate requirements; and work with stakeholders to develop transaction standards and other operational solutions to enable accurate and efficient implementation of both the surprise billing protections and good faith estimates.