FAH Hospital Policy Blog

Perspectives on health policy affecting America's hospitals and the patients we serve.

Surprise Billing | FAH Policy Blog Team

FAH Files Comments on Surprise Billing Requirements

Today, FAH filed comments with the Secretaries of HHS, Labor, and Treasury (Becerra, Walsh, and Yellen, respectively) regarding the Requirements Related to Surprise Billing, Part II interim final rule (IFR). It implements key provisions of the No Surprises Act, such as the independent dispute resolution process and provider good faith estimates for consumers.

The letter expresses FAH’s strong opposition to the IFR’s creation of a presumption that the qualifying payment amount (QPA) is the appropriate payment amount for qualified IDR items and services. The letter asserts that the presumption is inconsistent with the statute’s text and purpose, will result in certified IDR entities selecting payment amounts that do not best represent the value of the qualified IDR item or service, undermines the open negotiation process set by statute, and risks spillover effects that harm patients without offsetting benefits. It also details a number of issues with the IDR process, for example, good faith negotiations during the 30-day open negotiation process, batching of items and services in the IDR process, and IDR entity conflicts of interest. The letter also extensively outlines a number of issues with the good faith estimates that providers are required to furnish to consumers and makes recommendations aimed at appropriately narrowing when a good faith estimate is required.

You can read the entire letter here.