Certain policy decisions and challenges in implementing the No Surprises Act have undermined the unbiased and timely process Congress intended and contributed to a higher-than-anticipated volume of disputed claims, AHA told the House Ways and Means Committee in a statement submitted for a hearing Sept. 19 on the law’s implementation.
 
Among other recommendations, AHA said the agencies should revise their batching and bundling guidance and maintain the IDR administrative fee at $50; monitor insurers’ qualifying payment amount calculations and incentivize their participation in the open negotiation process; and require payers to use Remittance Advice Remark Codes and make timely payments.
 
Witnesses at the hearing included Jim Budzinski, executive vice president and chief financial officer for Wellstar Health System in Georgia, who shared the system’s experience with the IDR and payment processes implemented under the law. 

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