Diverse Stakeholders Urge Rulemakers to Ensure No Surprises Act Implementation Protects Patients and Decreases Health Care Costs
In order to ensure that the No Surprises Act is implemented in a way that protects patients and lowers health care costs, nearly 50 organizations representing consumers, employers, patients, and workers have sent the following letter to the Biden administration.
The groups are specifically asking the Departments of Health and Human Services, Labor and Treasury to follow through on the promise of the No Surprises Act to eliminate surprise medical billing and safeguard consumers from provider charges that increase out-of-pocket costs and raise consumer premiums. They emphasize that Congressional intent can only be honored by drafting regulations that make the qualifying payment amount (QPA), on which patient cost-sharing is based, the primary factor in resolving payment disputes, as the plain legislative language of the No Surprises Act makes clear.
The letter was signed by a diverse group of stakeholders, including Families USA Action, American Benefits Council, AFL-CIO, Leukemia & Lymphoma Society, the ERISA Industry Committee, Purchaser Business Group on Health, U.S. PIRG, and UniteHere.
The goal of the letter is to highlight that there is broad consensus among key constituencies for prioritizing protecting the health and financial well-being of patients in accordance with the legislation. Congress passed the No Surprises Act with the intention of delivering financial relief to consumers by reigning in outrageous and unfair provider charges – which should in turn lower health care premiums and reduce patient cost-sharing.
“Out-of-network balance billing has plagued consumers for decades and has left families on the hook for hundreds, thousands, and tens of thousands of dollars for bills they did not have reason to expect and are often unable to pay,” said Jane Sheehan, Director of Federal Relations at Families USA. “There is also strong evidence that the abusive practice of balance billing has contributed to higher premiums and health care costs for everyone with commercial insurance. In implementing the No Surprises Act, the Biden Administration has an opportunity to go a long way in providing families with the financial security they need, and it can make important strides toward reining in industry abuses that lead to inflationary health care costs.” She added, “the law will only meet that potential if forthcoming rulemaking follows Congressional intent and keeps the Qualifying Payment Amount central in payment disputes, maximizing the law’s potential to hold down costs.”