Key Congressional Committee Urges Fixes to Flawed NSA Implementation

The leadership of the House Ways and Means Committee released a strongly worded letter to three cabinet secretaries urging “swift action” to address a major error in the August 26, 2022 No Surprises Act (NSA) final rule.  Representatives Richard Neal and Kevin Brady, the Chairman and Ranking Member of the Committee and co-authors of the NSA, affirmed that the law requires an independent dispute resolution (IDR) arbiter to equally consider a full range of factors when adjudicating a payment dispute between a physician and insurer.  Neal and Brady underscored that the August 26 final rule continues to direct arbiters to unlawfully give preference to the insurer-calculated qualifying payment amount (QPA) in IDR deliberations. The letter notes, “Although the qualifying payment amount (QPA) is an important factor, the statute lists the QPA as one of many factors an IDR entity must consider without giving preference or outsized weight to any one factor.”  The unlawful weighting of the QPA is currently the subject of a Texas Medical Association (TMA) lawsuit.  The suit seeks a correction of the final rule to align it with the NSA statutory language. ASA has filed an amicus brief in support of the TMA’s position.