STAT+: No Surprises Act arbitration rule could worsen flood of provider disputes

Health insurers, providers, and consumer advocates praised the Trump administration’s long-awaited fixes to the No Surprises Act’s arbitration process, but some warned they won’t address its most pernicious problem: the provider gaming that’s costing millions. 

The final rule issued Thursday makes changes designed to improve communication between insurers and providers and give Medicare more visibility into their negotiations. Other tweaks are aimed at attacking the problems of ineligible disputes and of arbitration being used as a catch-all instead of a last resort. 

“It does make meaningful progress to reduce burdens and streamline, but we need additional action to address some of the underlying incentives that are driving overuse of the process,” said Jennifer Jones, the Blue Cross Blue Shield Association’s senior director of legislative and regulatory policy. “We need more to address the egregious award amounts.” 

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المصدر: STAT News