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
AHA Feb. 15 reiterated its support for the Future Advancement of Academic Nursing Act, recently reintroduced by Sen. Jeff Merkley, D-Ore., and Rep. Lauren…
Headline
The House Ways and Means Committee Jan. 19 voted 40-3 to advance the Tax Relief for American Families and Workers Act of 2024 (H.R. 7024). The bill includes an…
Headline
In an interview Jan. 17 in the Washington Post’s Health 202 newsletter, AHA President and CEO Rick Pollack explains why ‘site-neutral’ Medicare proposals…
Headline
As the first of two deadlines to fund the federal government approaches Jan. 19, the Coalition to Protect America’s Health Care yesterday launched a television…
Headline
The departments of Health and Human Services, Labor and Treasury Dec. 15 reopened the federal independent dispute resolution portal to process all dispute…
Headline
The departments of Health and Human Services, Labor and the Treasury Dec. 15 reopened the federal independent dispute resolution portal to process all dispute…