Physicians exploring options to speed up legal timetable in surprise-billing suit against feds
The American College of Radiology and two other physician societies are exploring options to speed up their court battle with the Biden administration over its implementation of a law banning surprise medical bills.
ACR, alongside groups representing anesthesiologists and emergency physicians, first filed suit against the feds on Dec. 22, hoping to halt a key provision of the rule it created to enact the No Surprises Act. The government now has until early March to respond, but the three professional organizations want a faster resolution since the change took effect on Jan. 1.
“This case will lack many usual features, such as discovery or witnesses,” the college said in a Jan. 6 news update. “This is because the lawsuit only challenges one aspect of the No Surprises Act—how the federal government will determine paying members for their services if they are out of network. With a focused lawsuit, the ACR does not need extensive review of the government’s evidence to support its rulemaking. Rather, the ACR will emphasize demonstrating harm to its members—and ultimately patient care—as quickly as possible.”
The societies filed their complaint in a Chicago federal district court following similar suits from the American hospital and medical associations and the Lone Star State’s top physician advocacy group. Texas Medical Association organizers are now attempting to raise money to fund their ongoing legal battle.
All of the lawsuits concern one key component of rulemaking related to the arbitration process under the No Surprises Act. Physicians and hospitals have said they support the goal of protecting patients from financial harm. However, they believe the Biden administration has failed to honor Congress’ original intent when it passed the legislation in late 2020. They believe the final process places too much power in the hands of insurers, with dispute-resolution centered on the median network rate for services, allowing insurers to drag down reimbursement and carve providers out of their networks. North Carolina has become ground zero for such concerns, after the local Blue Cross Blue Shield started circulating letters asking docs to accept sizable reductions in pay.
But until and unless a court intervenes, the No Surprises Act is now the law of the land. ACR shared a separate post on Jan. 6 with guidance for physicians on handling billing in 2022, including links to resources. The Centers for Medicare & Medicaid Services also released additional info, including an FAQ and guidance on the new dispute-resolution process. The American Hospital Association has its own webpage, too, while another guide is available from the American Medical Association here.
States that have their own surprise billing laws are now navigating implementation. CMS released even more guidance on this front. And in a third post Thursday, the American College of Radiology reported that Washington State has introduced legislation that would align its local law with the federal version.
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.