Regulators Have Completely Rewritten the No Surprises Act

FOR IMMEDIATE RELEASE
October 12, 2021
+1 (202) 823-2333

WASHINGTON — During the most recent stakeholder briefing hosted by HHS and CMS on new regulations for the No Surprises Act, we were stunned by what was revealed...

...A senior official in the Office of Health Plan Standards and Compliance Assistance at the Department of Labor stated, and we quote,

"QPA is an appropriate benchmark for the out-of-network payment.”

This begs the question: have regulatory agencies been asleep for the past two years, or are they intentionally planning to destroy patients, physicians, and hospitals by ignoring Congress and pre-weighting health insurance plans' preferred payment (QPA)?

  • More importantly, we, along with a majority of healthcare stakeholders, are shocked that this new interim final rule (IFR) completely rewrites the most critical part of the law — the independent dispute resolution (IDR) process for payment disagreements.

Today, Action for Health is urgently reminding all stakeholders upon the release of these Part II regulations what Congress actually wrote in the No Surprises Act.
NO BENCHMARKING
And ALL factors and data brought before the IDR entity shall be considered equally
  • For further evidence that this extremely important patient protection law is being hijacked by unelected bureaucrats in favor of gigantic insurance companies, see below from bipartisan members of both the House and Senate that spent years working tirelessly to enact this legislation.
"Despite the careful balance Congress designed for the IDR process, the September 30, 2021 interim final rule with comment strays from the No Surprises Act in favor of an approach that Congress did not enact in the final law and does so in a very concerning manner."
"To match Congressional intent, your implementation of the law should ensure an IDR process that captures the unique circumstances of each billing dispute and does not cause any single piece of information to be the default one considered."
"We wrote this law to establish an arbitration system that is accessible and fair for all parties and gives equal weight to all arbitration considerations put forward in the statute."
The Biden administration should be forewarned. In response to regulators' complete betrayal of not only patients and our healthcare heroes, but also the administration's own comprehensive equity and competitive agendas, lawsuits, injunctions, and protests are coming.

This second IFR must be drastically changed before the No Surprises Act goes into effect next year.
####

Action for Health is a 501(c)(4) national non-profit patient advocacy organization. The organization educates policymakers, the media, and concerned citizens about critical healthcare issues.