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AMA, AHA drop their surprise billing lawsuit


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.

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