MEC Practice Academy 11.19
|Articles|September 21, 2022

AMA, AHA drop their surprise billing lawsuit

Author(s)Todd Shryock

Original suit was against the interim rule

The American Medical Association and American Hospital Association have filed to dismiss their lawsuit against the federal government over the No Surprises Act. The groups sued over last year’s interim rule, released last year.

The original complaint focused on how the federal government implemented the law through the rulemaking process and argued it heavily favored insurers during the arbitration process. When the final rule was released, the lawsuit became moot, though the groups still say the rule departs from Congress’ intent, and may file another lawsuit.

As part of the arbitration process between payers and providers, CMS said arbiters should start with the median in-network rate for a specific service and a specific region. In the interim rule, CMS said arbiters should presume this rate is appropriate for out-of-network services, which the AMA and AHA object to, because it essentially sets a price ceiling.

When the final rule was released, that language was removed.


Related to this article

Stroke survivors get a first-of-its-kind anticoagulant; Queens day care director admits $127M Medicare, Medicaid fraud; ovarian cancer may leave an early mark in the blood — Morning Medical Update © kwanchaichaiudom - stock.adobe.com
The top news stories in medicine today: The FDA approves the first factor XIa inhibitor to reduce the risk of a repeat stroke; a Queens adult day care program director pleads guilty in a $127 million Medicare and Medicaid fraud scheme; researchers tie a blood RNA signal to the precancerous stage of ovarian cancer.