Surprise Billing Regulation a Gift to Payers, Blow to Providers
Healthcare industry groups representing providers are upset with the latest surprise billing regulation detailing the independent dispute resolution process. The American Medical Association (AMA) is calling the latest in a series of surprise billing regulations “an undeserved gift to the insurance industry that will reduce [healthcare] options for patients.” The statement comes as the Biden-Harris Administration seeks to button up implementation of the No Surprises Act by the end of the year. The Act prohibits surprise medical billing in most situations by making it illegal for providers to bills patients more than the in-network cost-sharing amount for care. The latest regulation seeking to implement the ban on surprise billing detailed the independent despite resolution (IDR) process by which payers and providers will settle reimbursement rates for out-of-network care that would have resulted in a surprise bill for patients. The regulation released late last week included details,...