IS AMERICAN MEDICINE A GIANT CON?

Is The Era of Trusting Doctors And Hospitals Over? What Is The No Surprises Act?

What Is The No Surprises Act?

Why AMA backs Texas doctors’ lawsuit on No Surprises Act provision

CLARITY FROM CHAOS GUEST: Dr. Daniel J. Haller, MD is a general surgeon practicing in Long Island, NY. Dr. Haller filed a federal lawsuit in federal challenging the “No Surprises Act,” a bill passed in 2020, which barred doctors in hospitals from billing patients fair rates if they are out of network.

No Surpise: The No Surprises Act Punishes Doctors, Panders to Insurance Carriers

The AMA and the American Hospital Association (AHA) support a Texas Medical Association (TMA) lawsuit challenging the Biden administration’s final rule implementing the independent-dispute resolution process created by Congress and contained in the No Surprises Act.

“Hospitals and doctors strongly believe that no patient should fear receiving a surprise medical bill and that patients should be kept out of the middle of any billing disputes between providers and commercial health insurance companies,” says a joint statement from the AMA and AHA. The organizations’ focus continues to be on ensuring that the independent dispute resolution process between health plans and physicians (or hospitals) outlined in the statute is implemented fairly by the Administration.

The two associations said they plan to file an amicus brief supporting the TMA lawsuit (PDF), which was filed in the U.S. District Court the Eastern District of Texas and names as plaintiffs the U.S. departments of Labor, Treasury, and Health and Human Services, along with the secretaries who lead each department.

The AMA and AHA also noted that the amicus brief will explain how the final rule departs from congressional intent—just as the September 2021 interim final rule did.

“The Texas court previously held that the interim final rule impermissibly rewrote clear statutory terms by placing a thumb on the scale in favor of commercial insurers,” the AMA-AHA statement says. “The final rule suffers from the same problems.”

Dr. Daniel Haller is a general surgeon in Rockville Centre, New York and is affiliated with multiple hospitals in the area, including Mercy Hospital-Rockville Centre and St. Catherine of Siena Hospital. He received his medical degree from Technion-Israel Inst of Technology Faculty of Medicine and has been in practice between 11-20 years.