Today, ASA applauded recent guidance issued by the Center for Consumer Information and Insurance Oversight (CCIIO) that clarifies that anesthesiologists and other physicians may batch their disputed No Surprises Act (NSA) claims by issuer. In a letter to ASA President Michael Champeau, M.D., Jeffrey Wu, Deputy Director for Policy Director of CCIIO responded to recent ASA meetings with the Center to make clear that claims batched by the same issuer may be submitted to the independent dispute resolution (IDR) process, even if the claims are from different group or individual plans offered by the issuers. Batching by issuer will reduce the cost and improve the efficiency of ASA member submissions to the IDR process. ASA members who continue to have difficulty with IDR entities not accepting batches by issuer are directed to notify CCIIO.
In addition to batching by issuer, ASA has also repeatedly urged CCIIO to permit batching of ALL anesthesia claims by the same issuer, regardless of CPT code. ASA’s request would permit anesthesiologists and their practices to submit larger batches of claims to the IDR process for a single fee in lieu of smaller batches of 1-2 claims, each requiring a fee. ASA has argued that an issuer’s payments for anesthesia services are based on a similar anesthesia conversion factor that is used across all of the issuers’ CPT anesthesia codes. Accordingly, the IDR entity should be permitted to resolve a dispute by making a determination about the appropriate anesthesia conversion factor for the entire batch of the issuers’ anesthesia services. ASA will continue to advocate for more expansive batching of anesthesia services.
Date of last update: March 17, 2023