AHA opposes proposed fee increases for No Surprises Act IDR process

Commenting Oct. 26 on a Health and Human Services, Labor and the Treasury proposed rule that would increase the administrative fee and certified entities fee under the No Surprises Act’s independent dispute resolution process, AHA said it supports the proposal to use the Administrative Procedure Act process to establish the fees, but opposes the proposed fee increases and using an inflationary adjustment for future increases. AHA also raised concerns with the methodology for determining the administrative fee and opposes giving IDR entities more flexibility in setting their fees.

“Specifically, with regard to an IDR entity using a tiered pricing approach for batched determinations, the AHA recommends that a single hospital claim with multiple lines should be exempt from the tiered batched pricing and charged a fixed fee,” AHA said.
 
In August, a federal judge in Texas ordered the agencies to vacate nationwide a federal fee increase and batching rule for the IDR process for certain out-of-network providers and group health plans because they violate the APA’s notice-and-comment requirement.