ERIC did urge the administration to designate urgent care centers as emergency departments to reduce confusion about classification, because it currently varies state by state. (Photo: Shutterstock)
Several leading industry associations are weighing in on the Biden administration's interim final rule on surprise medical billing during the public comment period.
"It is vital that the final rule allows the No Surprise Act to be implemented as Congress intended while also safeguarding patients from surprise medical bills, lowering costs and strengthening employer-sponsored health insurance for millions of Americans and their families," said James Gelfand, executive vice president, public affairs, for the ERISA Industry Committee (ERIC).
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The organization's comments focused on the qualifying payment amount, which it said will lower patient costs and ensure fair market payment by minimizing reliance on outside resources such as state all-payer claims databases. Additionally, the final rule addresses the difference in geographic regions and insurance markets, ensuring that payment amounts are determined using locally negotiated rates that reflect the market conditions where a patient receives care.
America's Health Insurance Plans also expressed support for the act.
"No American should worry about receiving a surprise medical bill and the financial harm that can result," wrote Matthew Eyles, president and CEO. "That is why AHIP remains eager to engage with the administration as well as other health-care stakeholders — including employers, providers, facilities, state governments and consumers — to ensure the No Surprises Act is implemented in an efficient and effective manner.
"We strongly supported legislative efforts to ban the practice of surprise medical billing. This egregious business model went on for far too long and eroded Americans' confidence in our health-care system while harming the financial security of millions of families each year."
ERIC also supports provisions that protect patients from surprise bills issued by out-of-network providers at an in-network facility by requiring a 72-hour notice period. Patients will be better informed going into an appointment, enabling them to seek in-network options that will not levy additional charges, it said.
However, ERIC cautioned the administration to consider if urgent care centers are likely to include costly out-of-network services such as labs or radiology. If so, then ERIC urges the administration to designate the centers as emergency departments to reduce confusion about classification, because it currently varies state by state.
"Surprise medical bills serve only one purpose, and that is to make money off of unsuspecting Americans in their time of need," Gelfand said. "The administration's final rule must be firm in its intent to end this predatory practice and protect all Americans."
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