The EDPMA’s Study on The No Surprises Act and its ineffective IDR process prove this legislation threatens the nation’s healthcare system.
The No Surprises Act has emboldened many providers and organizations to advocate for fair treatment, including these examples from its second year in effect.
Access to the federal IDR process now requires a $350 fee. Formerly $50, the 600% increase in fees has ruffled many feathers.
ACEP and EDPMA came together to express the shortcomings and outline recommendations for the NSA in a letter to HHS, Labor, and Treasury departments.
Even before the No Surprises Act’s official implementation, a variety of physician organizations have advocated for an improved IDR process, as it favors insurers in its current state. Here are some examples of advocacy from the AAOS and ASA, among others, published before 2022.
While emergency physicians perform procedures and tests based on their patient’s condition, insurance companies downcode, often based upon the final diagnoses and, in some cases, for no bonafide reason. Insurance carrier motivation is frequently just a means of reducing reimbursements.
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