AHA, AMA Urge Appeals Court to Invalidate NSA Dispute Resolution Process
IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
Texas Medical Association; Tyler Regional Hospital, L.L.C.; Doctor
Adam Corley, 笔濒补颈苍迟颈蹿蹿蝉鈥揂辫辫别濒濒别别蝉,&苍产蝉辫;
v.
United States Department of Health and Human Services; Department of Labor; Department of the Treasury; Xavier Becerra, Secretary, U.S. Department of Health and Human Services; Julie A. Su, Acting Secretary, U.S. Department of Labor; Janet Yellen, Secretary, U.S. Department of Treasury, 顿别蹿别苍诲补苍迟蝉鈥揂辫辫别濒濒补苍迟蝉. _____________________________________
Lifenet, Incorporated; East Texas Air One, 笔濒补颈苍迟颈蹿蹿蝉鈥揂辫辫别濒濒别别蝉,&苍产蝉辫;
v.
United States Department of Health and Human Services; Xavier Becerra, Secretary, U.S. Department of Health and Human Services; United States Department of the Treasury; Janet Yellen, Secretary, U.S. Department of Treasury; United States Department of Labor; Julie A. Su, Acting Secretary, U.S. Department of Labor; United States Office of Personnel Management; Kiran Ahuja, 顿别蹿别苍诲补苍迟蝉鈥揂辫辫别濒濒补苍迟蝉.
On Appeal from the United States District Court
for the Eastern District of Texas, Tyler Division
BRIEF FOR AMICI CURIAE AMERICAN HOSPITAL ASSOCIATION AND AMERICAN MEDICAL ASSOCIATION IN SUPPORT OF PLAINTIFFS-APPELLEES
Zhen He Tan AKIN GUMP STRAUSS HAUER & FELD LLP 100 Pine Street, Suite 3200 San Francisco, CA 94111 |
James E. Tysse Kelly M. Cleary AKIN GUMP STRAUSS HAUER & FELD LLP 2001 K Street, N.W. Washington, D.C. 20006 202-887-4000 jtysse@akingump.com |
Counsel for Amici Curiae 黑料正能量 Association and
American Medical Association
INTRODUCTION
No one disputes that Congress鈥檚 principal intention in enacting the No Surprises Act (NSA) was to shield patients from unexpected medical bills. The AHA, the AMA, and their members strongly support this goal. But in 鈥渢ak[ing] the consumer out of the middle鈥 of billing disputes, Congress understood the need to establish a fair mechanism for healthcare providers and insurers to determine fair payment among themselves. H.R. Rep. No. 116-615, at 56-58 (2020) (quotation marks omitted). To 鈥渟trike[] an appropriate balance,鈥 Congress coupled a 鈥渂enchmark rate model鈥 with an independent dispute resolution (IDR) process. Id. Under this 鈥渂aseball-style鈥 process, id., arbitrators 鈥渟hall consider鈥 a list of statutorily enumerated factors in deciding between an insurer鈥檚 or provider鈥檚 offers, 42 U.S.C. 搂 300gg-111(c)(5)(C). The AMA and AHA supported this congressionally designed compromise, which both protected patients from surprise medical bills and established an intentionally balanced approach that did not skew towards either providers or insurers.
View the detailed brief below.