1/ The “No Surprises Act” is deeply flawed. It should not advance in its current form. Work must continue to reach a meaningful remedy to “surprise medical bills” #SMB that keeps patients out of the middle and provides balance.

Here are several concerns w/ the current proposal:

2/ The proposal should require that the initial “interim payment” made by the insurer for out-of-network services be considered the plan’s offer for IDR, to incentivize the insurer to pay a fair initial reimbursement.

But, the proposal does not.

3/ The proposal should allow the IDR process to consider UCR and an independent charge-based database. Lest it be a form of price-fixing by insurers since the qualifying payment is indexed to the insurer-set in-network median rate (w/CPIU adjustment).

But, the proposal does not.

4/ The proposal should avoid a complex administrative burden that threatens practice viability and leads to consolidation and higher healthcare costs for patients. Cost effective independent physician practice provides patients choice.

But, the proposal does not.

5/ The proposal should explicitly prohibit the IDR process from considering Medicare, Medicaid, and other public payer rates. These are well known to be below the cost of providing care and these programs are not implicated by the #SMB provisions.

But, the proposal does not.