The American College of Radiologists (ACR) and two other societies this week urged the release of a final rule related to the No Surprises Act (NSA) independent dispute resolution (IDR) process.
In an October 23 bulletin, ACR shared details of its October 20 letter to the U.S. Departments of Treasury, Labor, and Health and Human Services about the matter
"The previous administration had been delayed in releasing a final rule, which as proposed, included policies that we believe will greatly improve efficiency and decrease unnecessary utilization of the Federal IDR process," stated the letter, co-signed by ACR, the American College of Emergency Physicians (ACEP), and American Society of Anesthesiologists (ASA).
The rule is currently listed on the Administration’s Unified Agenda for potential November 2025 action after stalling since summer 2024 despite rounds of public comment, according to the group.
"Many of the policies in the proposed rule, if finalized as proposed, would address some of the significant issues our members continue to experience with the Federal IDR process," ACR, ACEP, and ASA noted.
However, calculation of qualifying payment amounts (QPAs) -- related to median contracted rates -- remains a significant issue on several fronts, they said. In some cases, for example, the QPA for service billed is not being clearly identified as required by statute.
Also, "health insurers often fail to provide the QPA at all, failing to comply with one of the most basic requirements of the No Surprises Act," the letter continued. "Further, health insurers often present QPAs that are so inexplicably low that they are clearly calculated incorrectly."
The issues leave providers with nowhere to go when health insurers present patently incorrect QPAs, stated the authors, who requested safeguards and requirements to ensure that the QPA is calculated correctly. Furthermore, they asked for increased enforcement of critical No Surprises Act requirements.
Read the entire letter here.
