Rep. Miller Highlights Flawed Implementation of the No Surprises Act in Ways and Means Committee Hearing

WASHINGTON, D.C. -  Congresswoman Carol Miller (R-WV) questioned Dr. Seth Bleier, Vice President of Finance, Wake Emergency Physicians Professional Association during a Ways and Means Committee hearing on the flawed implementation of the No Surprises Act (NSA) by the Biden Administration. The bipartisan No Surprises Act has was into law by President Donald Trump in 2020 and aims to protect patients from surprise medical bills.
 

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Congresswoman Miller began by highlighting the lack of clarifications in the No Surprises Act for ground ambulance services:
One concern I have about the No Surprises Act’s implementation is that Congress was very clear that ground ambulance services were not included in the NSA. However, I understand that some insurers are telling customers that ground ambulance services are subject to the NSA.
 
I would also like to note that the failure of CMS to issue a clarification is creating real problems. Rural ground ambulance services are particularly harmed because they are often small companies or businesses with very limited resources — and many are struggling just to keep their doors open.
 
Reports that some insurers are trying to force these rural providers to use the time consuming and IDR (Independent Dispute Resolution) process — when they are not even subject to it nor do they have an established qualified payment amount — this is concerning to me.
 
I am dismayed CMS hasn’t issued the written clarification that would solve this confusion, and I hope this is an issue we will continue to keep an eye upon.


Congresswoman Miller questioned Dr. Bleier on how the No Surprises Act implementation affects rural staffing shortages:

“One issue that we hear about time and time again is the lack of staffing available in our health care workforce. In rural areas, it’s becoming harder and harder to find physicians that are willing to practice where their reimbursement rates are much lower. This is due to the coverage-mix of their patients.
 
Can you speak further about how compliance with the NSA, as implemented by this administration thus far, has contributed to physician burnout in your workforce — and how this might influence physicians looking to start their careers in a rural area?” asked Congresswoman Miller.
 
“I think physician burnout is very high on emergency physicians for a wide range of reasons, going back toward the COVID pandemic. It’s a little bit of a moral hazard right now, physicians would always want to do right by their patients, and we try to do the best we can,” said Dr. Bleier. “When this law was passed as a bipartisan piece of legislation, we thought it was a great advancement. We did not think we would be affected by it because we have been in network with all the major pairs in our region but then we were kicked out of network. It’s like putting salt in a wound quite frankly for us, because not only are our providers working as hard as they can to do the best they can in very adverse circumstances, but when on top of that, their reimbursement, their fair market reimbursement is cut, it makes it very damaging to them.
 
It puts us in a very difficult position, and we want to do right by the patients. We want our resources not going to an IDR process. We want them to go towards our providers, working in the emergency department to provide the very best care they can in these rural emergency departments or any emergency departments we work at,” concluded Dr. Bleier. 
 

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