TAPP Signs Onto Letter Expressing Concerns with the Implementation of the No Surprises Act

TAPP and 11 other organizations recently signed a letter challenging the Biden Administration on its mismanagement of the No Surprises Act. The No Surprises Act was created to resolve billing debates and to protect patients against surprise medical bills. However, the Biden Administration has failed to implement this legislation properly, and patients are paying the price.

The Biden Administration has completely ignored the Independent Dispute Resolution process within the No Surprises Act, allowing insurers to manipulate the system and harm patients. Some specific, documented violations of the Independent Dispute Resolution include:

  • Payers informing providers that arbitration awards from the Independent Dispute Resolution process are “unenforceable.”

  • Misreporting of the patient cost-share on Explanation of Benefits and claim documents, despite National Security Agency protections. In other words, payers are informing patients and their doctors that their cost responsibility is greater than what the provider is allowed to bill.

  • Reports that after a bill is sent to the Independent Dispute Resolution process, some payers are converting the Independent Dispute Resolution award amount to become the patient’s responsibility. The result is a potential surprise out-of-pocket expense to patients in clear violation of NSA prohibitions.

Since the No Surprises Act has been enacted, these violations have increased at a dangerous rate. The violations above do not just hurt patients financially, they also threaten access to care and the physical health of patients. 

In addition to the violations damaging the physical and financial wellbeing of patients, the mismanagement of the No Surprises Act is another example of legislation that lowers America’s international standing and global superiority in healthcare.

It is clear the No Surprises Act is harming American patients in a number of ways, and it is crucial that adjustments are made to improve its current implementation. Read the full coalition letter here.

Ainsley Shea