U.S. Reps. Tom Suozzi (D-NY), Brad Wenstrup (R-OH), Raul Ruiz, MD (D-CA), and Larry Bucshon, MD (R-IN), were joined by 148 of their House colleagues in a Nov. 5 letter to the Biden administration expressing their displeasure with the “surprise billing” interim final rule (IFR) released Sept. 30. The American College of Radiology® (ACR®) expresses gratitude to ACR members who responded to Calls to Action to ask their congressperson to sign the surprise billing letter.
The letter, addressed to the secretaries of U.S. Departments of Health and Human Services, Labor and the Treasury, reiterated the congressional intent for the qualified payment amount to be one of many equally weighted factors to be considered during the independent dispute resolution process. Unfortunately, the administration has chosen to make the qualified payment amount the primary consideration, establishing a de-facto benchmark payment.
While the IFR achieves our shared goal of removing patients from the middle of payment disputes between physicians and insurers, the ACR agrees with the letter signors that the surprise billing law will result in narrower provider networks, potentially drastic imaging cuts regardless of network status and reduced patient access regardless of their insurer, if implemented as the rule is written.
The ACR will continue to explore all possible options to ensure the surprise billing law is implemented in a manner consistent with Congressional intent while ensuring physicians and providers have access to a fair dispute resolution mechanism.