Families USA Action led 27 organizations in submitting comments to the administration on the first set of rulemaking that will implement the landmark No Surprises Act. The letter was signed by national, state, and regional organizations representing patients and consumers who have been plagued by the uncertainty and financial burden of surprise medical bills. Signers include MomsRising, Community Catalyst, the Arthritis Foundation, and the National Alliance on Mental Illness.

The No Surprises Act was critical legislation that will protect consumers, but implementation matters. We are overall pleased with the first interim final rule and our comments offer recommendations to further strengthen. Our comments are aimed at ensuring the No Surprises Act provides families with the financial security they need and makes strides toward reining in industry abuses that lead to inflationary health care costs.

The No Surprises Act comment letter specifically expands on the following feedback:

  • Consumer interests must be central in rulemaking.
  • Consumers need strong standards around post-stabilization care and reasonable travel distance to protect them from unreasonable transfers and discharges.
  • The definition of “facilities” in this regulation should be broadly defined to ensure consumers have robust protections from surprise billing. Urgent care facilities and additional facilities must be included.
  • The No Surprises Act’s qualifying payment amount (QPA) should be an accurate and fair representation of the median in-network rate to ensure consumer cost-sharing is reasonable and health care costs do not further rise.
  • A minimum initial payment must be established to limit the number of cases that go to arbitration and to incentivize providers to join networks.
  • Disclosure requirements must ensure consumers have access to clear and consistent information about the prices they could face and their protections.
  • The administration must ensure notice and consent regulations are designed to protect consumers and do not allow any loopholes for providers to balance bill.
  • The consumer complaints process must be an equitable and transparent experience for consumers, and consumers must have access to assistance to navigate the new protections.
  • In future rulemaking, the administration should design the independent dispute resolution process to be predictable, fair, and a last resort for providers and plans, in order to prevent further inflation of health care costs.Click here to read the letter.