February 07, 2023

ACR Statement on Texas Federal Court Surprise Billing Case Ruling

The American College of Radiology released the following statement in response to the Feb. 6 U.S. District Court for the Eastern District of Texas ruling that parts of the independent dispute resolution (IDR) process in the Surprise Billing Final Rule violate the Administrative Procedure Act and are not consistent with the text and intent of the No Surprises Act by making the “qualifying payment amount” the primary factor in provider-payer out-of-network care payment disputes.

The judge stated, "the Final Rule [Aug. 19, 2022]…continues to place a thumb on the scale for the QPA by requiring arbitrators to begin with the QPA and then imposing restrictions on the non-QPA factors that appear nowhere in the statute."

Attribute to Jacqueline A. Bello, MD, FACR, chair of the American College of Radiology Board of Chancellors.

“Patients and their providers are again the winners with this ruling. The American College of Radiology® will continue to work to ensure that the IDR process complies with the No Surprises Act and is accessible, fair and efficient.

“This victory, which does not affect patient protections or costs, and only impacts the insurer-provider payment dispute process, leaves work to be done. Providers, insurers, regulators, lawmakers and other stakeholders must work together to ensure that sensible, balanced, physician-informed and patient-centered solutions are implemented to ensure access to care as we continue to shield patients from surprise medical bills.”