Radiology providers see improvement, but continued concern in ‘No Surprises’ medical billing proposal

Radiology providers say they see promise in new bipartisan, bicameral legislation to address surprise medical bills, while also expressing ongoing concerns.

Lawmakers last week unveiled the “No Surprises Act,” which would require that insurers make payments to radiologists and other providers either through negotiation between the two sides, or an “independent dispute resolution process.” In a statement issued Wednesday, the American College of Radiology said the policy framework is an “improvement” over previous proposals, including the elimination of a minimum threshold for arbitration.

However, the college “remains concerned” that plans such as Medicare, Medicaid and worker’s comp are not excluded from the independent reviewer’s consideration

“The ACR appreciates Congress’ work to protect patients from unexpected medical bills and establish a fair and equitable system to resolve physicians-insurer payment disputes,” Howard Fleishon, MD, chairman of the college’s board of chancellors, said in a Dec. 16 statement. “We urge lawmakers to engage with providers to make final improvements to the plan to gain a sensible policy that protects patients and patient access to care.”

In its own comments submitted to House and Senate leaders Wednesday, the Medical Group Management Association similarly praised the inclusion of an IDR process. But it’s worried that lawmakers are moving too fast, with some pushing to pass a bill by the end of 2020.

“We are concerned that stakeholders have had limited opportunity to thoroughly review and provide meaningful input on this consequential bill prior to inclusion in any end-of-the year legislative package,” Anders Gilberg, senior VP of government affairs for the MGMA, which represents 55,000 practice leaders across the U.S. including radiology, wrote Dec. 16. “We urge you to allow additional time for MGMA and other stakeholders to work with Congress to address concerns with certain aspects of the legislative language.”

The American Hospital Association added Dec. 14 that it “strongly supports” provisions to protect patients from surprise bills. However, it has “significant concerns” with parts of the No Surprise Act aimed at creating “unworkable billing processes and transparency provisions that are duplicative and costly without clear added benefit for patients.”

“We ask that any savings associated with this legislative initiative be directed to those providers that are on the front lines of treating COVID-19 patients, such as hospitals, physicians and nurses,” the AHA added.