Congress passed the No Surprise Act last year to protect patients from unexpected medical bills. This bipartisan piece of legislation is being celebrated as a victory by everyone involved — an increasingly rare sight in Washington, D.C. these days. Unfortunately, insurers are already taking advantage of the way the Biden administration enforces the law.

The American College of Emergency Physicians (ACEP) supports patient protections in the No Contingencies Act, but the law’s implementation language completely ignores Congress’ intent to create an equitable and independent dispute resolution (IDR) process.

While the law instructs arbitrators in the IDR process to consider all information shared by insurers and physicians, the government considers the eligible payment amount (a subjective rate set by the insurer) as a major factor in the process. This sets an artificially low benchmark payout that insurers can use to lower their payouts and drive more doctors out of the network.

As soon as the government announced its plans, emergency physicians received a chilling letter from Blue Cross Blue Shield, North Carolina, threatening to terminate their in-network agreement unless doctors received a 20 percent reduction in reimbursement for necessary medical care. Why the sudden change? Blue Cross Blue Shield directly cited the implementation of the No Accidents Act as its rationale.

Likewise, UnitedHealthcare is trying to coerce doctors into accepting a 40% pay cut or lose their contracts.American College of Emergency Physicians will retain remind lawmakers Regarding these powerful strategies, because unless they are blocked, insurance companies are here to stay.

It is important to understand how these strategies affect patients. Emergency departments, especially those in small or rural communities, will be forced to make difficult decisions about how to allocate already thin resources to continue treating patients. Options on the table include laying off staff, changing hours, and adjusting workloads so they can meet their legal obligations to stay open 24/7 and see every patient who comes in the door—during the pandemic, when they are already understaffed. and faced severe job burnout.

Things have been tough for emergency physicians — especially those who practice on their own. Bad behavior by insurers — such as canceling contracts and refusing to pay for services — continues to weigh on many doctor-run groups that have succumbed to the pressure.

Insurers are choosing policies that put emergency departments at risk of closing, with the help of regulatory language that guides the NSA’s implementation. It’s heartbreaking, but more importantly, it’s dangerous. It’s impossible not to worry about the safety of thousands of people, especially in small towns or underserved areas, where the next available emergency doctor also takes hours.

From a practical and immediate point of view, the implementation of this law will impair the ability of frontline professionals to treat patients during the surge, whether that means caring for large numbers of Covid-19 patients, victims of mass casualties such as shootings, or providing Helps people who have a heart attack or drug overdose.

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Insurers argue that cutting physician reimbursement will create opportunities to make coverage affordable for everyone. Yet insurance companies make profits year after year, while the cost of employer-sponsored home health insurance is rising.according to Kaiser Family Foundation, the financial burden of deductibles has increased by 92% over the past decade.

The layoffs facing North Carolina’s emergency departments could be catastrophic at any time, but they hurt even more during the pandemic when health care providers are already exhausted, overworked and under mounting financial pressure.

Congress crafted the No Surprise Act to create an impartial process for resolving billing disputes. When the government sets the rules for implementation, they fundamentally change the compromise that everyone involved has spent years negotiating. These dangerous modifications are untenable.

ACEP, American College of Radiology, and American Society of Anesthesiologists are take legal action A last-minute change to reverse the federal government. We will work to ensure that the No Accidents Act addresses the Contingency Act as Congress intended, rather than allowing insurers to twist the legislation to their advantage — leaving patients and doctors in apathy.