Radiologists, anesthesiologists and EM docs jointly praise No Surprises Act changes

Radiologists, anesthesiologists and emergency medicine physicians are jointly praising recently announced changes to the No Surprises Act while also pushing for further reform. 

Medical societies representing all three specialties shared their official response to the independent dispute resolution, or IDR, final rule on Friday. Released by the Centers or Medicare & Medicaid Services May 28, the rule finalizes many updates to the NSA first proposed back in 2023.

The American College of Radiology, American Society of Anesthesiologists and the American College of Emergency Physicians commended the rule, calling it a “thoughtful and collaborative approach.” They see the changes as an “important step forward,” one that will hopefully create a “more functional, transparent dispute resolution system.” 

“The final rule addresses persistent challenges that have kept physicians from effectively using the IDR,” ACR CEO Dana Smetherman, MD, MBA, MPH, said in a statement May 29. 

Smetherman highlighted some of the most significant improvements made in the final rule. These include reducing the regular administrative fee radiology groups must pay from $115 per party, per dispute down to $15. She also touted strengthened transparency requirements, including new standardized Claim Adjustment Reason Codes and Remittance Advice Remark Codes, “which can give physicians a clearer understanding of which claims are eligible for IDR and help reduce unnecessary disputes.” 

ACR, ASA and ACEP—which have previously lobbied together on NSA issues, with the three specialties heavily impacted by surprise billing—also highlighted “important reforms” to the IDR process itself. These include clearer timelines, enhanced communication standards and stronger expectations for good-faith engagement during open negotiations.

However, the specialty societies cautioned that finalizing the rule “does not end the work.” They believe these reforms only will matter if backed by “rigorous, consistent enforcement and real consequences for insurance companies that fail to comply.” This is particularly pertinent for insurers that delay or withhold payments after a radiologist or other doc prevails in the IDR process. 

“These operational improvements must be paired with sustained oversight to ensure the system functions as Congress intended,” the statement charged. 

ACR, ASA and ACEP said the three societies also recently met with the White House Office of Management and Budget about challenges with the No Surprises Act. They emphasized the urgency of enacting reforms to keep the IDR system functioning. All three societies said they plan to work closely together to “ensure the law is implemented effectively.” 

“Physicians need a dispute resolution system that is predictable, efficient, and grounded in transparency,” ACEP President L. Anthony Cirillo, MD, said in the statement. “This final rule represents meaningful progress toward that goal and will help restore confidence in the process.”