AAMS worked closely with Congress on legislative language for the No Surprises Act (NSA) that protects patients from balance billing and establishes a fair and transparent independent dispute resolution (IDR) process for resolving payment disputes. The NSA states that IDR entities should consider the qualified payment amount (QPA) calculated by insurers as one of many relevant factors when determining the out-of-network rate payable to air ambulance providers; the NSA does not say that the QPA is the presumptive out-of-network rate or that it should receive greater weight than any other factor under consideration.
AAMS fully supports the prohibition of balance billing of patients as well as data collection provisions and the considerations of cost, quality, and good-faith efforts to negotiate with insurers as part of the independent dispute resolution (IDR) process passed into law by the No Surprises Act. As we work with federal agencies and our larger healthcare partners, it is our goal to ensure this process does not give too much leverage to insurers over the arbiter’s decisions in the IDR. AAMS supports a fair and equitable process that doesn’t overly rely on the influence of either party. This is a position supported by all healthcare providers, including the American Hospital Association and the American College of Emergency Physicians.
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