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- AMA, AHA File Lawsuit Over No Surprises Act Implementation
The American Hospital Association (AHA) and American Medical Association (AMA) filed a lawsuit against the federal government over the misguided implementation of the federal surprise billing law on December 9. The CAP also has strongly opposed the federal regulations that give insurance companies the upper hand during what should be an impartial, independent dispute resolution (IDR) process as set in the No Surprises Act.
The No Surprises Act takes patients out of the middle of billing disputes between physicians and commercial health insurers and is set to take effect January 1, 2022. According to the lawsuit, certain provisions in the regulations implementing the law place a heavy thumb on the scale on the IDR process, which now benefits the interests of health insurance companies. The skewed process will ultimately reduce access to care for patients, the associations said.
The CAP has urged the Biden Administration to revise the regulation to align the law’s implementation with the original legislation. Specifically, the regulation for the IDR process disregarded Congress’s intentions to create a fair system where physicians and health insurers can resolve disputes without one factor having more weight over others in the final payment determination.
The AHA, AMA, and their co-plaintiffs filed their lawsuit against the departments of Health and Human Services, Labor, and Treasury, along with the Office of Personnel Management in the US District Court for the District of Columbia. Read the filed complaint and motion to stay.