ACEP is deeply concerned that by requiring arbiters to greatly prioritize the artificially low Qualified Payment Amount (QPA) set by insurance companies, rather than giving equal weight to a mix of other factors, the new rule as written undermines the entire process.
A true solution to surprise bills must acknowledge the role that insurance companies have in these billing disputes and recognize the root cause of the issue – narrow insurance networks.
Instead, this approach could drive rates lower and encourage insurance companies to narrow their networks even further, which would make it harder for patients to get emergency care. This approach threatens the viability of physician practices and makes it harder for emergency physicians to care for patients, particularly in small or rural communities.
Chief Operating Officer