ASA Expresses Opposition to Elevance Policy in Meeting

ASA working in partnership with the American College of Emergency Physicians (ACEP) and the American College of Radiology (ACR), convened a joint meeting with the payer Elevance to address its proposal to impose a 10% payment penalty on facilities that allow out-of-network clinicians to practice. The meeting followed a formal statement of opposition issued to Elevance by the organizations.

ASA was represented by ASA President Patrick Giam, MD; President-Elect Jeff Mueller, MD, FASA; First Vice President Kraig S. de Lanzac, MD, MBA, FASA; and Immediate Past President Donald E. Arnold, MD, FACHE, FASA. ASA and representatives from ACR and ACEP strongly objected to this punitive approach, highlighting the serious operational, financial, and clinical consequences for hospitals and patients. They urged Elevance to abandon the policy that inappropriately seeks to leverage hospitals to pressure physicians into network participation.  Representatives of Elevance acknowledged that only a small fraction of claims are disputed.

However, the company cited rising out-of-network costs and the growing volume of No Surprises Act (NSA) Independent Dispute Resolution (IDR) cases as justification for this harmful policy. ASA, ACR and ACEP will continue joint efforts to counter this policy.