Surprise billing experts recently discussed how the No Surprises Act is providing essential patient protections to help to decrease costs for Americans.
During a briefing to provide updates on the No Surprises Act, industry officials discussed amicus briefs filed in response to the third lawsuit from the Texas Medical Association, seeking to alter the QPA and raise health care costs for patients in the process. Each speaker reiterated the No Surprises Act continues to work for patients, which prevented 9 million surprise bills during the first 9 months of 2022.
As legal challenges to the law, implementing regulations, and IDR decisions continue, it is essential that the Administration stand firm to protect patients and the cost saving measures of the No Surprises Act.
Key takeaways included:
- “The No Surprises Act prevented more than 9 million bills in the first 9 months of 2022 at a rate of 1 million bills prevented per month. 12 million bills were not sent to patients in 2022 who otherwise would’ve faced crippling medical debt.” – Kinika Young, Director of Legal Advocacy at the Leukemia & Lymphoma Society
- “Congress passed the No Surprises Act to achieve 2 primary goals: one is protecting patients from the most common types of surprise out of network bills and two is lowering health care costs. The first three lawsuits filed by TMA threaten the second goal of lowering health care costs.” – Kinika Young, Director of Legal Advocacy at the Leukemia & Lymphoma Society
- “If plaintiffs get their way it would increase health care costs and those costs will likely be passed off to consumers and patients in the form of higher insurance payments. Also, the QPA serves as the basis for calculating patient cost sharing amounts. Increasing the QPA would increase the patient cost sharing amount. Where the No Surprises Act sought to take patients out of payments disputes between plans and providers, this lawsuit threatens to drag patients and consumers back into the fight.” – Kinika Young, Director of Legal Advocacy at the Leukemia & Lymphoma Society
- “We describe it as a death by a thousand cuts strategy where the plaintiffs in this case continue to attempt to dismantle the No Surprises Act piece by piece.” – Katy Johnson, Senior Health Policy Counsel at the American Benefits Council
- “It’s really important that providers and plaintiffs in this case not be able to change the rules in ways that would inflate the [QPA]. We explain our support for the agency’s rules, how not only are they reasonable and justified but are consistent with the policy goals of the No Surprises Act.” – Katy Johnson, Senior Health Policy Counsel at the American Benefits Council
- “What we know for certain is the No Surprises Act is saving patients money and giving them greater peace of mind knowing not only that they won’t receive a surprise bill months after they leave the hospital, but they have lower and more predictable cost sharing.” – Adam Beck, Senior Vice President of Commercial Product & Employer Policy at AHIP
- “What we do have data on is who is initiating these disputes. Who is driving what a CMS official last week called an astronomical number of disputes. And that’s because in the report the Administration released on the 23rd, we can see three quarters of all disputes in the first year were coming from ten entities including one out of three of all disputes that were non air ambulance in the entire country came from just one staffing company. Eight out of ten of those entities are backed by private equity.” – Adam Beck, Senior Vice President of Commercial Product & Employer Policy at AHIP
- “It’s become clear that the No Surprises Act is working for patients, it’s just not working for private equity. And that’s why you’ve seen this aggressive litigation strategy.” – Adam Beck, Senior Vice President of Commercial Product & Employer Policy at AHIP
- “If the No Surprises Act works the way that it’s supposed to and saves the money for taxpayers that the Congressional Budget Office anticipated, then that’s a blow to private equity backed physicians. So, let’s not confuse one judge’s rulings and an onslaught of disputes from private equity staffing firms as an indication that the No Surprises Act isn’t working or that there is a nationwide problem across the board.” – Adam Beck, Senior Vice President of Commercial Product & Employer Policy at AHIP