AHA, AMA urge appeals court to invalidate NSA dispute resolution process 

The AHA and American Medical Association Sept. 18 urged the U.S. Court of Appeals for the 5th Circuit to affirm a district court decision that invalidated a No Surprises Act final rule that favors insurers in the independent dispute resolution process and threatens serious harm to the law’s patient protection goals.  

“Amici agree with Plaintiff-Appellees that the challenged rule is unlawful,” the organizations said in a friend-of-the-court brief filed in the case. “They submit this brief to emphasize why it is also unworkable as a practical matter, to rebut specific points made by the amici supporting the Departments, and to explain the detrimental impact the rule would have on the ability of physicians and hospitals to provide their patients with the excellent care they deserve.” 

In particular, the brief argues that “the Final Rule places a heavy thumb on the scale in favor of insurers in the IDR process—indeed, it is deliberately designed to have that effect. On multiple occasions the Departments have been found to have acted in a manner contrary to the [No Surprises Act] and the Administrative Procedure Act (APA)—each time issuing rules that systematically disadvantage providers.”   

On Aug. 24, the U.S. District Court for the Eastern District of Texas for a third time ruled certain regulations implementing the No Surprises Act invalid. The Centers for Medicare & Medicaid Services has temporarily suspended the IDR process as a result, including the ability to initiate new disputes.