American College of Radiology contemplating legal action to halt provision in surprise billing law

The American College of Radiology is contemplating legal action to halt a controversial provision in legislation to address surprise medical bills, according to an update shared Thursday.

Late last month, the Texas Medical Association filed suit against the Biden administration, claiming the feds failed to follow congressional intent in a recently released interim final rule. Lawmakers had laid out a robust process to settle disputes between insurers and out-of-network providers to keep patients from receiving unexpected IOUs. But Texas docs argue the rule ignores such parameters, creating a process that heavily favors payers.

ACR highlighted the lawsuit in a Nov. 4 update and said it is crafting a response to the interim final rule while contemplating other options.

“In addition, the ACR and other medical associations, including the American Medical Association, are considering other avenues to ensure the [independent dispute resolution] section of the rule is revised to accurately reflect congressional intent, including filing or joining a lawsuit,” the college wrote. “Prior to the ACR determining its level of participation/commitment in any legal action, several essential factors—such as the basis for legal argument, the jurisdictional venue and additional plaintiffs—would need to be considered.”

An American Medical Association spokesman could not confirm or deny the doc group’s interest in pursuing legal action Friday, only saying AMA is “looking at all options.”

ACR said the Texas lawsuit echoes several of its concerns related to surprise-billing legislation, believing the final rule “shatters” a rare bipartisan agreement to address this issue. Beyond potentially pursuing legal action, the college is also working with several House representatives on a letter urging the secretaries of several agencies to fix the legislation. Thus far, 118 lawmakers have already signed the letter.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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