In November 17, 2021, correspondence with several cabinet level agencies, the AACU joined more than 100 state medical associations and national medical specialty societies in urging reconsideration of the regulations implementing the No Surprises Act (NSA) that direct arbitration entities to consider the offer closest to the qualifying payment amount (QPA) as the appropriate payment amount for out-of-network services.
The letter concludes:
..we believe that the NSA was drafted in a purposeful way to meaningfully protect patients from surprise billing while ensuring important checks and balances on the provider-insurer contracting process. We urge you to correct the IFR’s deviation from that congressional balance and issue a final rule that does not include a rebuttable presumption that directs an IDR entity to consider the offer closest to the QPA as the appropriate payment amount, and confirms that an IDR entity has the discretion to consider all the relevant information submitted by the parties, as provided in the statute, to determine a fair out-of-network payment to physicians.