• Home
  • About Us
  • List of Health Insurance Companies

Health Plan News

Timely Health Plan News and Commmentary.

Health Plan News
Home Healthcare Plan News Emergency Department Practice Management Association Files Amicus Brief, Supports Patient Protections

Emergency Department Practice Management Association Files Amicus Brief, Supports Patient Protections

Posted on December 22, 2021 Written by Annalyn Frame

The Emergency Department Practice Management Association (EDPMA), an organization representing the practice of Emergency Medicine, filed an amicus brief, along with Texas ACEP and Virginia ACEP, in support of the Texas Medical Association’s and Dr. Adam Corley’s lawsuit against four federal agencies challenging the legality of an interim final rule issued in September implementing dispute resolution in the No Surprises Act (Rule).

Throughout the legislative process, stakeholders agreed that patients should be removed from billing disputes and held only to their in-network cost-sharing amounts. EDPMA strongly supports the patient protections. The lawsuit and amicus brief do not challenge these protections.

The amicus brief focuses on the process for resolving reimbursement disputes between insurance plans and physicians, with special emphasis on the adverse effects the Rule threatens to have on the delivery of emergency care. Early legislative proposals that relied on a benchmark set at the plan’s typical in-network rate were rejected in favor of a compromise that considered evidence submitted by both the plans and the physicians. The statute clearly provides that the arbiter “shall consider” eight factors before deciding appropriate payment. The interim final rule inappropriately prohibits the arbiter from considering seven of those required factors except in special circumstances. Instead, it requires the arbiter to pick the rate that is closest to the plan’s median in-network rate (a rate which is completely non-transparent to physicians).

“Congress was clear when it passed the landmark No Surprises Act last year: protect patients from unavoidable and unexpected costs without jeopardizing patient access to care,” said Don Powell, D.O., Board Chair of EDPMA. “The Rule will inevitably allow insurers to manipulate fair payment standards with little or no transparency on the health plan’s calculation of ‘median in-network’ rates. This will harm not just commercially insured patients, but the rural, medically vulnerable and indigent populations who rely on our nation’s emergency departments as an important safety net.

“With the COVID-19 pandemic, and the latest wave of new variants, emergency department safety net resources have been stretched to the breaking point. We see the Rule leading to dire effects on the overall viability of our emergency medical care system. We urged the Administration to amend the Rule to be consistent with the language of the statute and Congressional intent — and now we have filed an amicus brief in support of the lawsuit challenging the Rule’s legality.”

SOURCE Emergency Department Practice Management Association (EDPMA)

Filed Under: Healthcare Plan News

Recent News

  • Numinus completes acquisition of Novamind June 13, 2022
  • NRx Pharmaceuticals Provides Update on Breakthrough Therapy Designation (BTD) Request for ZYESAMI® (aviptadil) June 13, 2022
  • King Insurance Acquires Wurzel Insurance June 13, 2022
  • Medicare Advantage Plans Earn High Marks in eHealth Survey June 13, 2022
  • Curated Mental Health Partners with Brooklyn Minds Psychiatry April 20, 2022
  • HEALTHWORXS: A Game Changer, No Cost Healthcare Plan April 20, 2022
  • Study Finds Consumers Want Their Physician to Lead April 20, 2022
  • Peer-Reviewed Journal Spotlights Lirio’s Approach to Behavioral Design and Its Ability to Impact Underserved Communities April 20, 2022
  • Braxia Scientific Provides Update on Clinical Trials for Ketamine and Psilocybin Drug Development February 8, 2022
  • Numinus Identified as a Licensed Psilocybin Supplier January 31, 2022

About Annalyn Frame

I am a nursing student currently, but have been interested in healthcare since I was much younger. It’s as if I have always known that I would eventually end up being a nurse or going into the healthcare industry.

I am the editor of Health Plan News.

Search Our Site

Ketamine Therapy Dallas
Ketamine Treatment Clinic Dallas

Categories

  • AARP
  • Aetna
  • AMERIGROUP
  • Blue Cross Blue Shield
  • Canadian Health Care System
  • Canadian Pharmacies
  • Cardinal Health
  • Chubb
  • CIGNA HealthCare
  • COVID-19
  • diabetes
  • Enterologics
  • Facilities And Providers
  • FDA
  • GlaxoSmithKline
  • Health Clinics
  • Health Insurance Coverage
  • Health Plan Enrollment
  • Healthcare Companies
  • Healthcare Plan News
  • HealthSouth
  • Home Care
  • Home Health Care Insurance
  • Hospitals
  • Humana
  • J.P. Morgan Healthcare Conference
  • Lidocaine
  • LifeTree eClinical
  • Lipitor
  • Liposuction
  • MedBasics
  • Medicaid
  • Medical And Healthcare
  • Medical Devices
  • Medicare
  • Mevion Medical Systems
  • Mobile Healthcare
  • Pharmaceutical Companies
  • Senior News
  • The SCOOTER Store
  • Thoracic Surgeons
  • thrombocytopenia
  • Today Sponge
  • Top Health Care Networks
  • Total Lumbar Fusion Graft Spine Surgery
  • Toxic Air Pollution
  • Trans Fats
  • Travel Insurance
  • Triglycerides
  • Tuberculosis
  • Unilife
  • United Healthcare
  • UnitedHealth Group
  • Unused Medications
  • Uterine fibroids
  • Vaccines
  • varicella
  • Ventas
  • Vyteris
  • WakeUpWalmart
  • Wal-Mart Healthcare Crisis
  • Walgreens Pharmacy
  • Water Quality
  • WebMD
  • WellPoint
  • West Nile Virus
  • Wilmer Shields Rich Awards
  • World Health Care Congress
  • Wound Management
  • Zelnorm
  • Zocor
  • ZOLOFT

Pages

  • 1199 National Benefit Fund
  • A Little about Drug Preparation and Formulation Development
  • About Us
  • Affordable Health Insurance
  • Benefits of Hiring a Senior Caregiving Service
  • Catastrophic Health Insurance
  • Cheap Health Insurance
  • Cheap Health Insurance Plans
  • Child Health Insurance Plans
  • Choosing a Health Insurance Plan
  • Christian Health Insurance
  • Dental Assistants and Their Future
  • Dr. Howard Bellin: Questions about Rhinoplasty
  • Finding the Right Dentist
  • Get Your Winks in Blink
  • Health Insurance
  • Health Insurance Plans For Family
  • Health Sharing Plans
  • Healthcare and Hospitals: Disinfection is Key
  • High Deductible Health Plans
  • Home Care Employment in Arizona
  • How A Medical Weight Loss Plan Can Help You Get The Figure You Want
  • How Ketamine Therapy Helps Fight Depression
  • How Orthotic Insoles Improve Your Health
  • Individual Health Insurance Plans
  • Ketamine Uses and Benefits
  • List of Health Insurance Companies
  • Low Income Health Insurance
  • Medical Research Consultants
  • Personal Lubricants for Women – Liven Up Your Life!
  • Private Health Insurance Plans
  • Rhesus Negative
  • Self Employed Health Insurance
  • Short Term Health Insurance Plans
  • Student Health Insurance Plans
  • Temporary Health Insurance
  • The Basic Building Blocks For a Sustained, Healthy Diet
  • The Importance of Clinical Study Software
  • The Use of Post Cycle Therapy Supplements
  • Travel Health Insurance

Copyright © 2022 · Focus Pro Theme on Genesis Framework · WordPress · Log in

Go to mobile version