ACR applauds challenge to No Surprises Act

By staff writers

February 25, 2022 -- The American College of Radiology (ACR) applauded a decision this week by the U.S. District Court for the Eastern District of Texas to toss out portions of a rule covering arbitration between insurers and providers in the No Surprises Act.

The court found the government failed to follow the text of the No Surprises Act and proper notice and comment when it required arbitrators to select the amount closest to the median in-network rate in settling payment disputes between insurers and certain out-of-network healthcare providers, according to a February 24 report by Bloomberg Law.

The Texas Medical Association launched the challenge.

"The court's sensible ruling is a win for patients and providers. Insurers are already using the law's mis-implementation to raise profits by narrowing provider networks, which can strip patients of access to their chosen providers, reduce overall access to care, and delay diagnosis and treatment of illness and injury," said Dr. Howard B. Fleishon, chair of ACR's Board of Chancellors, in a statement.

The decision impacts only the insurer-provider payment dispute process in the final rule and not the law's patient protections, Fleishon added. The ruling can only benefit patients by helping to ensure that they continue to have access to their chosen providers in their communities, he said.

This week's decision in Texas is separate from the suit filed against the federal government by the ACR, the American Society of Anesthesiologists and the American College of Emergency Physicians.

Nonetheless, the ACR hopes this ruling is the first of a series of decisions that will force the agencies to implement the No Surprises Act exactly as Congress intended, Fleishon said.

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