April 25, 2022

ACR to Continue Federal Surprise Billing Implementation Lawsuit

Late Government Challenge of Texas Ruling Prompts ACR, ASA and ACEP to Press Forward with Joint Lawsuit

Three major medical associations will continue to press their federal lawsuit to block implementation of parts of the Surprise Billing Interim Final Rule in the wake of a last-minute government challenge to a Feb. U.S. District Court for the Eastern District of Texas ruling that vacated those parts of the rule.

The case filed by the American College of Emergency Physicians (ACEP), American College of Radiology® (ACR®) and the American Society of Anesthesiologists (ASA) has been stayed while the government determined whether it would appeal the Texas court ruling in the suit brought by the Texas Medical Association (TMA).

Now that the government has appealed the TMA decision, ACEP, ACR, and ASA stand ready to pursue their case to halt the government’s unlawful rule.

ACEP, ACR and ASA filed their suit to prevent insurer use of the rule’s independent dispute resolution (IDR) process to raise profits by narrowing medical networks, which denies patients their choice of providers and may delay diagnosis and treatment of illness and injury.

The Illinois and Texas cases solely impact the IDR process to determine provider reimbursement for out of network care. Neither case affects the No Surprises Act patient protections against out-of-network medical bills. Neither case would raise patient out-of-pocket costs.

ACEP, ACR and ASA will work with legal partners and patient advocates to ensure that the Surprise Billing Interim Final Rule ultimately complies with the text and spirit of the No Surprises Act as passed by Congress.