ACR praises legislation that would impose penalties on insurers for delayed NSA payments

The American College of Radiology (ACR) supports legislation that would impose fines on health insurers if they fail to pay doctors within 30 days after they lose an independent dispute resolution process, as established by the No Surprises Act (NSA).

Along with the American College of Emergency Physicians (ACEP) and the American Society of Anesthesiologists (ASA), the ACR commended bipartisan HR 9572, which was filed by U.S. House Representatives Greg Murphy, MD (R-NC); Raul Ruiz, MD (D-CA); John Joyce, MD (R-PA); Kim Schrier, MD (R-WA) and Jimmy Panetta (D-CA). The bill would further enforce the NSA of 2020, which provided protections for patients from “surprise” out-of-network medical bills and established a protocol for an independent dispute resolution process between insurers and providers and/or patients.

“The NSA requires insurers to pay physicians promptly,” ACEP said in a statement issued Sept. 13. “If a physician or practice believes the payment offered by the insurer is inadequate, they can challenge the payment using the NSA’s independent dispute resolution (IDR) process. If the independent arbitrator rules in the physician’s favor, the insurer must legally pay the physician the award within 30 days. Reports of insurers not paying these arbitration awards in a timely manner are commonplace.”

This follow-up legislation is vital to holding insurers accountable to the NSA mandate, said Alan Matsumoto, MD, in the ACEP statement. Matsumoto is chair of the ACR Board of Chancellors.

“There is a real need for accountability after disputes are resolved under the No Surprises Act, because insurance companies often simply do not pay at this time,” he said. “This situation can put clinicians in financial jeopardy, which in turn threatens the patient access to care that the No Surprises Act was designed to protect. The ACR supports this legislation and the continued work of its sponsors to protect the principles of the No Surprises Act.”