Anesthesiologist, Emergency Physician and Radiologist Groups Strongly Support New Legislation that Penalizes Insurers for Delayed Payments

WASHINGTON, D.C. – The American College of Radiology^® (ACR^®), American College of Emergency Physicians (ACEP) and the American Society of Anesthesiologists (ASA) strongly support H.R. 4710 / S. 2420, the No Surprises Enforcement Act, introduced yesterday that will fine health insurance companies that fail to pay physicians within 30 days after losing the independent dispute resolution (IDR) process laid out in the No Surprises Act (NSA).

 This legislation does not impact the important patient protections included in the NSA that ACR^®, ACEP and ASA advocated for and continue to fully support, nor does it raise patient out-of-pocket costs.

 The NSA requires insurers to promptly pay physicians. If a physician or a practice considers the payment offered by the insurer to be inadequate, they can challenge the payment by using the NSA’s IDR process. If the independent arbiter rules in favor of the physician, by law, the insurer must pay the physician within 30 days. Reports of insurers failing to timely pay these arbitration awards are commonplace.

 According to government data, insurance companies lose nearly eight out of 10 IDR cases to physicians or other providers.

“Insurance companies taking advantage of flaws in the NSA system jeopardizes the sustainability of anesthesia practices, threatening access to care,” said ASA President Donald E. Arnold, M.D., FACHE, FASA. “This legislation would hold big insurance companies accountable and shows a continued bipartisan interest in improving the No Surprises Act system.”

H.R. 4710 and its Senate companion S. 2420 will impose a penalty three times the difference between the insurer’s initial payment and the IDR entities’ ruling per claim. The claim will also be subject to interest. The House legislation was introduced by Rep. Greg Murphy, M.D., Rep. Jimmy Panetta, Rep. John Joyce, Rep. Kim Schrier, M.D., Rep. Bob Onder and Rep. Raul Ruiz, M.D. The Senate companion was introduced by Sen. Roger Marshall and Sen. Michael Bennett.

“Insurance companies must be held accountable to reimburse providers for the amount determined by the IDR process,” said Alan Matsumoto, M.D., FACR, chair of the ACR Board of Chancellors. “Now, insurers are often not paying at all for these services provided to patients. This refusal trend may threaten the ability of practices to provide services in their communities and restrict patient access to care that the NSA was supposed to protect.”

“This bipartisan bill takes critical steps to stop insurer bad practices,” said Alison Haddock, M.D., FACEP, president of ACEP. “The games insurers play have real consequences for physicians and patients, especially in rural and underserved communities. ACEP strongly applauds the introduction of this legislation and urges its prompt passage to make sure that insurance companies are not given a free pass to skirt the law and avoid their payment obligations."

ACR, ACEP and ASA urge Congress to pass this bill to ensure insurance companies pay physicians and their practices fairly and in a timely manner, so they may continue to care for their patients.

About the American College of Emergency Physicians
The American College of Emergency Physicians (ACEP) is the national medical society representing emergency medicine. Through continuing education, research, public education, and advocacy, ACEP advances emergency care on behalf of its 40,000 emergency physician members, and the more than 150 million people they treat on an annual basis. For more information, visit www.acep.org and www.emergencyphysicians.org. 

About the American College of Radiology
The American College of Radiology (ACR), founded in 1924, is a 42,000-member medical association serves patients and society by advancing the practice and science of radiological care through advocacy, quality standards, research and education. www.acr.org.

About the American Society of Anesthesiologists
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 59,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. Follow ASA on Facebook, X, Instagram, Bluesky, and LinkedIn.

# # #