The Texas Medical Association filed a second lawsuit against the federal government’s surprise payment arbitration process on Thursday.
The medical association alleges in its complaint with the Eastern District Court of Texas that an August rule for independent dispute resolution for unexpected medical bills still gives illegal priority to medical bills. insurance companies versus providers.
“We, again, demand that the legislation be followed as intended by Congress and that the challenged provisions be voided. There should be a level playing field for doctors and healthcare providers in billing disputes after they provide care,” said Texas Medical Association President Dr. in a press release.
The lawsuit comes shortly after the American Medical Association and the American Hospital Association dropped legal challenges to the policy. The AMA and AHA support Texas’ lawsuit. The organizations said in a joint statement on Thursday: “We intend to give our voice in this case by submitting an amicus brief explaining how the final rule differs from the intention of the nation. as the interim final rule in September 2021,” the organizations said in a joint statement Thursday.
The Texas Medical Association first sued regulators over arbitration policy last year. The provisional rule requires arbitrators to choose a surprise bill offer that comes closest to the insurance company’s contractual average on-net fee. Judge Jeremy Kernodle of the Eastern District Court of Texas ruled in favor of the Texas doctors in February.
The federal government appealed the decision in April, but later introduced a rule requiring arbitrators to consider both the insurance company’s contractual average net rate and additional information when decided to pay for an unexpected bill.
The Texas Medical Association argues that the final rule doesn’t go far enough to protect provider payments. The group argues in the report that the method of calculating average rates in the network of insurers is “deflationary” compared to the average actual policy rates of the insurers.
“These provisions of the final rule are clearly illegal and would unfairly falsify [independent dispute resolution] led to the backing of insurance companies, giving them a breath of fresh air that they couldn’t get in the legislative process. At the same time, they will undermine the ability of healthcare providers to receive full reimbursement for their services, to the detriment of both the provider and the patient they receive. service,” the complaint.
