October 21, 2021

Bipartisan US House Members Urge Colleagues to Sign Surprise Billing Letter

U.S. Reps. Tom Suozzi (D-N.Y.) and Brad Wenstrup (R-Ohio) are circulating a “Dear Colleague” letter asking other members of Congress to join them in urging the Biden administration to revise the Interim Final Rule (IFR) on surprise billing.

The letter, addressed to the secretaries of the U.S. Departments of Health and Human Services, Treasury and Labor, urges the IFR be revised to accurately reflect congressional intent as written in the No Surprises Act, passed by Congress as part of the Consolidated Appropriations Act of 2021.

The legislation defines a set of criteria that the arbiter must consider during the independent dispute resolution process, with each of the criteria being given equal weight. However, in the IFR, the administration specifies the arbiter must begin with the assumption that the “qualified payment amount” used to represent median in-network rates is the appropriate payment amount prior to considering other factors.

If the administration’s IDR approach is fully implemented, the American College of Radiology® (ACR®) and others believe this will establish a de facto benchmark payment rate and will result in a downward trend of in-network payment rates and/or physicians being forced out of insurer networks, ultimately making it harder for patients to find in-network care.

The ACR has issued a call to action to members encouraging them to contact their members of Congress and urge them to cosign the Suozzi/Wenstrup letter.

For more information, contact Rebecca Spangler, ACR Director of Government Affairs.