Health economics and policy experts explain to the courts why they should reject challenges from national and state healthcare provider groups to one of the rules of the No Surprises Act (NSA), aimed to limit surprise bills for out-of-network health services.
Erin Trish, Assistant Professor and Co-Director of the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California, along with several other prominent healthcare economic and policy scholars, coauthored amicus briefs in American Medical Association, American Hospital Association et al. v. U.S. Department of Health and Human Services, in Association of Air Medical Services v. U.S. Department of Health and Human Services et al., and in Texas Medical Association et al. v. U.S. Department of Health and Human Services et al.
The briefs apply current healthcare research and established economic principles to examine the NSA’s rule for resolving disputes between healthcare providers and payers over out-of-network payment. According to the challenged rule, the historical median in-network rate for similar medical services will be used to guide the dispute resolution unless providers or payers can demonstrate evidence that a different payment amount is appropriate.
The amici provide economic evidence demonstrating that the proposed regulation will generate outcomes consistent with Congressional intent, namely that patients’ healthcare plan premiums will remain steady or decline without limiting patients’ access to in-network providers or reducing payments to providers to below-market rates.