Surprise Billing Ban Could Be Fueling ER Staffing Firms’ Financial Woes

Regulators on Sept. 20 released the latest in many iterations of rulemaking related to the No Surprises Act (NSA), the 2021 law that banned surprise medical billing. Meanwhile, one expert tells AIS Health, a division of MMIT, that evidence is growing that insurers have gained a notable advantage in rate negotiations with emergency departments.

The new proposed rule deals with fees related to Independent Dispute Resolution (IDR), the arbitration system set up by the NSA. Previous rulemaking, which was challenged in court by provider groups, required each party to pay $350 per case when they submit a batch of cases to an IDR entity. The new proposed rule requires each party to pay $150 per case, according to Manatt, Phelps & Phillips LLP partner Harvey Rochman.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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