American College of Radiology urges Biden administration to fix holes in surprise billing legislation
The American College of Radiology is urging the Biden administration to fix holes in a recent ban of “surprise” medical bills for out-of-network care.
ACR said it supports the No Surprises Act, authorized as part of year-end legislation in December, and its goals to keep patients out of reimbursement disputes, and address the adequacy of payment networks. However, the college is concerned gray areas give health insurers leeway “that could be used as leverage to disrupt good-faith negotiations.”
“While the intent of the NSA is clear — to end surprise billing while preserving access to care — there are a number of policies in the act that require further clarification through rule-making,” ACR leadership wrote in a May 11 letter to new Health and Human Services Secretary Xavier Becerra.
The college asked for insight into how HHS will qualify provider payment amounts for the No Surprises Act, meld these changes with state laws, and steer independent arbitrators resolving physician-insurer disagreements. CEO William Thorwarth Jr. also emphasized that “most of radiology is practiced in-network,” noting that the specialty has accounted for only 1% of payment disputes under New York state’s long-running local surprise-billing legislation.
“The ACR believes that fair payment mechanisms are necessary to ensure adequate reimbursement for out-of-network services in order to support a sustainable healthcare system,” he wrote. “By promoting good faith negotiations between payers and providers, and including mechanisms that promote network contracting, the [No Surprises Act} represents a reasonable solution to this issue.”
You can read the full letter with the rest of the college’s suggestions here.
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.