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EDPMA Supports Texas Medical Association’s Opposition to a 600% Increase in Administrative Fees For Physicians Utilizing No Surprises Act Independent Dispute Resolution

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The dramatic, unprecedented increase in initial fees disproportionately affects providers, favors health plans, and will hurt patients.


MCLEAN, Va. (PRWEB)

The Emergency Department Practice Management Association (EDPMA) fully supports the Texas Medical Association’s lawsuit holding the Department of Health and Human Services, Department of Labor and the Department of Treasury (the Departments) accountable and demanding they reverse its 600% administrative fee increase for clinicians to participate in the Independent Dispute Resolution (IDR) process as intended by the No Surprises Act.

The Texas Medical Association’s (TMA) fourth lawsuit filed against the federal government asserts that the Department’s unlawful exorbitant administrative fee increase to initiate the IDR process harms physicians and the patients they serve. This 600% increase in the non-refundable fee must be paid by disputing parties to access the Federal IDR process and is a substantial obstacle for physicians’ ability to seek redress for unsubstantiated underpayments from health plans for services provided to insured patients seeking emergency care. The dramatic, unprecedented increase in initial fees disproportionately affects providers, favors health plans, and will hurt patients.

“While EDPMA understands CMS’ need to address the IDR backlog, exorbitant fees are simply not the answer. These abrupt, inappropriate increases unnecessarily burden emergency medicine clinicians and significantly deter clinicians’ access to the method of dispute resolution provided by Congress. This is another substantial misstep that fails to address fundamental operational and policy-related issues involved in the No Surprises Act,” said Don Powell, DO, FACEP, EDPMA Chair.

“CMS’s actions prevent the level playing field provided in the law, and contrary to the law’s interests, will drive more payer-driven contact terminations, while crippling the cash flow that supports emergency care for patients,” says Powell.

EDPMA fully supports the Texas Medical Association and their lawsuit to protect patients, physicians and the healthcare system, and urges the Departments to reinstate the originally announced $50 federal IDR administrative fee.

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About EDPMA

The Emergency Department Practice Management Association (EDPMA) is the nation’s largest professional physician trade association focused on the delivery of high-quality, cost-effective care in the emergency department. EDPMA’s membership includes emergency medicine physician groups of all sizes, as well as billing, coding, and other professional support organizations that assist healthcare providers in our nation’s emergency departments. Together, EDPMA’s members deliver (or directly support) health care for over half of the 146 million patients that visit U.S. emergency departments each year. Visit http://www.edpma.org.

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