EDPMA Supports The Texas Medical Association’s Lawsuit And The Implementation of the No Surprises Act As Intended


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TMA’s claims align with EDPMA members’ experiences. Our members represent about half of all emergency department visits in the nation and fully support the No Surprises Act and its intent to keep patients out of the middle of payment disputes.

The Emergency Department Practice Management Association (EDPMA) fully supports the Texas Medical Association’s efforts to hold accountable the Department of Health and Human Services, Department of Labor and the Department of Treasury (the Departments) to ensure fair and equitable implementation of the No Surprises Act as intended.

The Texas Medical Association’s (TMA) third lawsuit filed against the federal government, asserts that the methodology to calculate the Qualified Payment Amount (QPA) is not only flawed, but favors commercial health plan insurers and violates the Congressional intent of the No Surprises Act. The suit calls into question the Departments’ methodology that ultimately drives down the QPAs resulting in under-reimbursement of healthcare providers.

“TMA’s claims align with EDPMA members’ experiences,” says Don H. Powell, DO FACEP, EDPMA Chair of the Board. “Our members represent about half of all emergency department visits in the nation and fully support the No Surprises Act and its intent to keep patients out of the middle of payment disputes. In a recent member study, emergency medicine physician practices are estimated to lose $1 billion annually because of inaccurate QPA calculations and the overburdened and inadequate independent dispute resolutions process.”

“If the current NSA methodology goes unchecked, this model will cripple those who staff emergency departments, shut down ERs and eliminate access to communities nationwide, especially in rural and underserved areas. At some point, emergency physician groups will not be able to adequately staff emergency departments. This will lead to holes in the healthcare safety net which could lead to longer waits for emergency care or the inability to deliver care in emergency departments,” says Powell.

EDPMA fully supports the Texas Medical Association and their lawsuit to protect physicians and the healthcare system.

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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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