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UrduIn its fourth ruling regarding the flawed implementation of the No Surprises Act, the U.S. District Court for the Eastern District of Texas agreed with the plaintiffs, the Texas Medical Association, that the government was incorrectly permitting insurers to use a faulty methodology when calculating their median in-network rate, also known as the qualifying payment amount (QPA). This TMA III ruling does not impact the patient protections included in the No Surprises Act that the American College of Radiology® (ACR®), (ACR), American College of Emergency Physicians (ACEP) and the American Society of Anesthesiologists (ASA) advocated for and continue to fully support, nor does it raise patient out-of-pocket costs.
Tag: No Surprises Act
Medical associations commend Texas federal court Surprise Billing ruling—a win for patients and physicians
The American College of Radiology® (ACR®), American College of Emergency Physicians (ACEP) and American Society of Anesthesiologists (ASA) applaud the Aug. 3 U.S. District Court for the Eastern District of Texas’ ruling that the government’s exorbitant 600% fee increase to access the independent dispute resolution (IDR) process and its overly-restrictive “batching” limitations violate federal law. The ruling does not impact the patient protections included in the No Surprises Act, which ACR, ACEP and ASA advocated for and continue to support, nor does it raise patient out-of-pocket costs.
Medical Societies Call Texas Federal Court Surprise Billing Case Ruling A Victory for Patients and Providers
The American College of Emergency Physicians (ACEP), American College of Radiology (ACR), and American Society of Anesthesiologists (ASA) are pleased that a Texas federal court ruled Feb. 6 in favor of the Texas Medical Association’s (TMA) second legal challenge to the improper implementation of the No Surprises Act (NSA).
Major Medical Societies Support Texas Medical Association Challenge to Flawed Qualifying Payment Amount
The American College of Emergency Physicians (ACEP), American College of Radiology® (ACR®) and American Society of Anesthesiologists (ASA) support a new Texas Medical Association (TMA) suit filed January 17, 2023, stating that key aspects of the federal government’s Surprise Billing interim final rule (IFR) are badly flawed, imposing serious financial pressures on all physicians and resulting in small, independent physician groups, in particular, needing to consolidate or close their practices; thereby causing patients to lose access to care, particularly in underserved areas.
Anesthesiologists Oppose 700% Increase in Fee to Access No Surprises Act Independent Dispute Resolution Process and Call for IDR Reforms
Today, the American Society of Anesthesiologists (ASA) expressed its outrage with the 700% surge in the No Surprises Act (NSA) administrative fee that must be paid by anesthesiologists to access the Federal Independent Dispute Resolution (IDR) system. ASA urges the government to block implementation of the massive fee increase and reform the IDR process.
American Society of Anesthesiologists Proposes Nine Recommendations to Address Flawed Implementation of No Surprises Act
The flawed implementation of the No Surprises Act has created profound financial challenges for community anesthesiologists’ practices that can be resolved through solutions proposed by the American Society of Anesthesiologists (ASA).
Current Insurer Calculation of Qualified Payment Amount for Out-of-Network (OON) Care May Violate No Surprises Act
In possible violation of the No Surprises Act, health insurance company calculations of Qualified Payment Amounts (QPA) for anesthesiology, emergency medicine and radiology services (and possibly other specialty services) likely include rates from primary care provider (PCP) contracts. A new study conducted by Avalere Health and commissioned by three national physician organizations examined a subpopulation of PCPs and determined that contracting practices may directly impact the QPA.
Legislation for Surprise Billing May Decrease In-Network Reimbursement
A new Harvey L. Neiman Health Policy Institute study, published in Radiology, reviewed the implications of unexpected out-of-network balance billing—commonly called surprise billing—on reimbursement for hospital-based specialties such as radiology. The analysis concluded that even physicians who never engaged in such billing practices may still be impacted by the No Surprises Act, which is due to take effect in 2022.