Connect with us

World News

Doctor, hospital lobbies move to dismiss lawsuit over surprise billing ban

Published

on

bG9jYWw6Ly8vZGl2ZWltYWdlL0dldHR5SW1hZ2VzLTEyNjIwMjY3NDUuanBn

This audio is auto-generated. Please let us know if you have feedback.

The American Medical Association and the American Hospital Association are seeking to dismiss their own lawsuit against the federal government over its implementation of The No Surprises Act.

Football Highlights

The two lobbying groups filed a motion on Tuesday in federal court seeking to dismiss their claims, along with co-plaintiffs Renown Health, UMass Memorial Health Care and physicians Stuart Squires and Victor Kubit. The motion comes before a status hearing Wednesday.

The groups filed suit over the interim file rule, which was released last year.

In their original complaint, the AMA and the AHA said they didn’t take issue with the law Congress passed in 2020 to ban surprise medical bills. Instead, they took issue with how the federal government chose to implement the law through the rulemaking process and alleged it deviated from Congress’ original intent and placed “a heavy thumb on the scale” that favored insurers during the independent arbitration process.

The lobbying groups believe the lawsuit became moot when the final rule on surprise billing was released last month, although the two said the final rule still departs from Congress’ original intent.

However, the two lobbying groups hinted another lawsuit may be on the way despite their bid to dismiss their claims.

The No Surprises Act takes patients out of the middle of payment disputes by setting up a process by which payers and providers can settle disputes through arbitration.

In the rule-making process, to give arbiters a place to start in thinking about payments, the CMS put weight on the qualifying payment amount, or the median in-network rate for a specific service in a specific region.

The interim final rule instructed arbiters that they “must begin with the presumption that the [qualifying payment amount] is the appropriate [out-of-network] amount.” It’s this instruction that has generated pushback from providers.

The QPA effectively sets a ceiling on prices, former AMA President Gerald Harmon told Healthcare Dive.

The final rule released last month nixes that contested language.

“Hospitals and doctors intend to make our voices heard in the courts very soon about these continued problems,” the two said in a joint statement provided to Healthcare Dive.

The case is currently before Judge Richard Leon of the District Court of Columbia and was consolidated into one case alongside the Association of Air Medical Services.

SEE IT HERE