Pallone & Murray Voice Support for Biden Administration’s Surprise Billing Implementation Rule
House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (D-WA) wrote to Health and Human Services (HHS) Secretary Xavier Becerra, Treasury Secretary Janet Yellen, and Labor Secretary Martin J. Walsh today voicing support for the Biden Administration’s Interim Final Rule (IFR) implementing key provisions of the No Surprises Act. The Committee Chairs also urged the Administration to proceed with the implementation of the IFR to protect consumers from surprise medical bills.
“As Committee Chairs with jurisdiction in the House and Senate over the No Surprises Act, we applaud the Biden Administration for diligently implementing the law’s landmark patient protections in a manner that is consistent with our intent,” Pallone and Murray wrote. “The bipartisan No Surprises Act will finally protect patients from the unfair practice of surprise medical billing and introduce much needed transparency into our health care system. We urge the Departments to continue to implement the law without delay so that patients do not have to wait any longer for these commonsense protections.”
Pallone and Murray were key leaders in passing the No Surprises Act in 2020 to protect patients from surprise medical bills and establish a fair payment resolution process between health care providers and health insurance plans.
“For too long, patients have been caught in the middle of billing disputes between providers and health plans,” the Committee Chairs continued in their letter. “After years of debate, Congress came to an agreement to comprehensively protect patients from surprise medical billing. The No Surprises Act limits what patients pay in surprise billing situations and establishes a federal independent dispute resolution (IDR) process to fairly resolve payment disputes between health plans and providers.”
In their letter, Pallone and Murray explain that the Biden Administration’s IFR follows through on their intent when drafting the law by instructing the IDR entity to consider the qualifying payment amount (QPA) as a reasonable rate while not precluding other information from being considered or preventing either party from submitting any offer they choose. They also note that Congress determined and made clear in legislation that an IDR process, like baseball-style arbitration, should focus on the QPA while providing flexibility for the IDR entity to consider additional relevant and credible information that may merit a departure from the QPA.
“We believe the IFR establishes an appropriate framework for disputes to be fairly resolved and is reflective of Congress’ agreement not to mandate a specific payment rate,” Pallone and Murray concluded. “The IDR process strikes the right balance among competing stakeholder requests for consideration of higher and lower payment rates. In addition, it is well established in the legislative language and economic analysis that the QPA was intended to be a driving factor in the IDR entity’s decision. We urge the Departments to move forward with the IFR to finally protect patients from this unjust practice. Further, we urge the Administration to implement the other provisions of the law not addressed in this or previous rules as soon as possible.”
To read the full letter, click HERE.