From the ACEP Advocacy Action Center: There is Still Time: We Need Your Help on Surprise Billing


There is still time to fight back and contact Congress about the second regulation released by the Biden Administration on surprise billing. A strong showing of bipartisan concern is critical to bring the Administration’s attention to the overreach and gross misinterpretation of the IDR section of this law and to compel their action to amend it to align with congressional intent.

Your advocacy is working, but we must keep the pressure on.

The letter circulating in Congress by Reps. Tom Suozzi (D-NY), Brad Wenstrup (R-OH), Raul Ruiz (D-CA) and Larry Bucshon (R-IN) is up to 124 signatures, equally supported by Democrats and Republicans in Congress. As stated in our communication to you last week, the letter addressed to HHS Secretary Becerra, Labor Secretary Walsh, and Treasury Secretary Yellen, urge their respective departments to follow the letter of the law and amend the IFR section of the No Surprises Act to align the law’s implementation with the legislation that Congress passed.

If you have not yet emailed your U.S. Representative, there is still time!

The second regulation, which sets forth how the critical independent dispute resolution (IDR) process will be implemented, is completely out of step with the final legislation, the No Surprises Act, that Congress voted on and passed last December. As intentionally designed by Congress, the IDR process was to offer a fair interaction between insurance companies and physicians once patients are out of the middle of billing disputes.

But instead, the new rule undermines the entire IDR process by requiring arbiters to greatly prioritize the artificially low Qualified Payment Amount (QPA), or median in-network rate, set by insurance companies, rather than giving equal weight to a mix of other factors which were prominently emphasized in the legislation (such as complexity of the case, level of training of the physician, etc.). 

This approach is sure to drive payment rates lower and encourage insurance companies to narrow their networks even further, which would make it harder for patients to get emergency care. We now fear the viability of physician practices is at stake, and it will be harder for emergency physicians to care for patients, particularly in small or rural communities. 

Click here to send a message to your U.S. House member. Ask them to sign on to the Suozzi/Wenstrup letter regarding the implementation of the IDR process in the No Surprises Act. 

We must keep the pressure on the Biden Administration to enact the changes necessary to make sure this important legislation is implemented as Congress intended. Let them know that now is not the time to take away resources from emergency physicians who are needed on the front lines in communities across the country.

The letter closes on November 5, so please contact your legislator as soon as possible.