AHA Feb. 5 voiced support for many provisions in a proposed rule to improve how the No Surprises Act independent dispute resolution process functions, but said the departments of Health and Human Services, Labor and the Treasury still need to address several issues critical to the functionality of the IDR process, including greater oversight of payers and accuracy and transparency in how they calculate the qualifying payment amount. 

“Hospitals and health systems report that payers consistently are not complying with IDR determinations, including one member who testified before Congress earlier this year that payers had made timely payment in only one-third of the disputes decided in the health system’s favor,” AHA wrote. “The health system was still owed $40 million in reimbursement for disputes that had been decided but for which the payer had not remitted payment within the required timeframe. This behavior cannot persist. The delay or loss of millions of dollars in reimbursement only harms patients by starving providers of the resources they need to deliver care. … We recognize that the departments are working on additional rulemaking related to the NSA, and we urge the departments to address these issues through that process.”

Related News Articles

Headline
The federal government shutdown is expected to continue into next week as the Senate adjourned Oct. 9 after failing to pass spending legislation; senators plan…
Headline
The AHA provided a statement of record to the Senate Special Committee on Aging for a hearing Oct. 8 on the pharmaceutical and medical device supply chains.…
Headline
The federal government shutdown will continue as the Senate Oct. 3 failed to adopt a government funding deal. The latest attempt to pass the House-passed…
Headline
The federal government shut down Oct. 1 following a failed Senate vote on the House-passed continuing resolution to fund the government by midnight Sept. 30.…
Headline
The AHA Sept. 24 expressed support for the Medical Student Education Authorization Act (H.R. 5428), legislation introduced in the House Sept. 17 that would…
Headline
The AHA expressed support Sept. 22 to House and Senate sponsors of the Medicare Advantage Prompt Pay Act (H.R. 5454/S. 2879), legislation that would apply a…