AMA, AHA, State Medical Groups Sue Feds —  Again — Over Surprise-Billing Rule

The Texas Medical Association, UT Health Tyler Regional Hospital and a physician filed a lawsuit Sept. 22 in federal court that once again challenges the arbitration process established under the No Surprises Act, Becker’s reports.

The same day, the American Hospital Association and the American Medical Association said they would be filing an amicus brief in support of the Texas lawsuit.

The 2020 No Surprises Act protects patients from unexpected medical bills and limits how much they can be charged for emergency and nonemergency services from out-of-network providers. It also established an arbitration process for when payers and providers disagreed about these rates.

Under an interim final rule unveiled in July 2021, CMS directed the arbitrator in the independent billing dispute resolution process to assume that the qualifying payment amount, or the median in-network rate set by payers, is the appropriate out-of-network rate. Read more.

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