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A Voice for Private Physicians Since 1943

The “No Surprises Act” is a Surprise Attack on Patient Choice and the Constitution

Dear AAPS Members and Friends,

Anytime Congress claims it is protecting patients, the alarm bells should start sounding. The “Patient Protection and Affordable Care Act” has of course harmed patients and increased costs. Likewise the “No Surprises Act” that was hidden inside a 5600 page bill that Congress passed hours after it was introduced, in the final days of the lame duck Congress, is a surprise attack on patients’ access to independent physicians.

Proponents claim the bill is needed to protect patients from so-called surprise bills.  Unfortunately, this problem caused in large part by past policy failures like ACA, is not going to be fixed by 357 new pages of federal regulation. 

In fact the legislation is full of bad surprises that will result in decreased patient choice and the closure of more independent medical practices. Not to mention the fact that many provisions are unconstitutional. The last thing we need during the current crisis when patient freedoms and the Constitution are already under attack are more restrictions and unconstitutional actions.

PLEASE CALL YOUR SENATORS AND HOUSE MEMBER ASAP. The Congressional Switchboard is (202) 224-3121. Alternately you can find your Senators’ phone numbers (or contact form) here and House member’s information here.

Ask your Members of Congress to “REPEAL the No Surprises Act.” Tell them it should be reversed before it takes away patient access to independent physicians who work for the patient and not for the benefit of the insurance plan’s bottom line.

Here are just a few of the problems with the bill:

It adds heavy-handed policies that reduce options for how patients can receive medical care from physicians. It adds red tape to both patients seeking care out-of-network and independent physicians providing that care.

Sections 103 forces an unwieldy arbitration process on out-of-network physicians tied to “median in-network rates.”

Section 104 prohibits out-of-network physicians from billing a fee that is different than the median rate. It contains a convoluted exemption process that is subject to being overruled by the Secretary of HHS and the exemption is not available to a number of specialties.

Section 112 apparently requires all physicians to provide anticipated CPT codes and ICD-10 codes 3 days in advance of a patient visit, even if no claim will be filed. How is it even possible to know 1 hour in advance what diagnostic code will be used, not to mention 3 days?

Section 115 creates federally funded claims databases inimical to patient privacy.

Other reasons to oppose the bill:

The bill will prohibit balance billing of patients by non-participating physicians in all emergencies, and in non-emergencies when the care is performed at participating facilities.

This may sound good to some but is a huge additional step towards socialized medicine. It means that  insurers and government bureaucrats will exert even greater control over patient care, especially care that is needed in emergency life or death situations.

Advocates of the bill say that “patients need to be removed from disputes between insurers and providers.”  In our view it is insurers that need to be extracted from getting in-between patients and doctors. Removing patients from the equation is exactly the wrong thing to do.  “Holding patients harmless” sounds compassionate but like all socialist policies will end up leading to rationing and a race to the bottom.

There is an exemption process to the balance billing ban available for non-emergency care provided by certain non-participating physicians, like the primary surgeons, if the patient signs a consent form at least 72 hours prior to the procedure.

Not eligible for the exemption are physicians in the following specialties: emergency medicine, anesthesiology, pathology, radiology, neonatology, assistant surgeons, hospitalists, and  intensivists.

Also not eligible for the exemption: “items and services provided by such other specialty practitioners, as the Secretary [of HHS] specifies through rulemaking.” This puts dangerous new power into the hands of the unaccountable bureaucrats.

And the exemption process would be prohibited for “items and services provided by a nonparticipating provider if there is no participating provider who can furnish such item or service at such facility.”

The bottom line? The bill greatly increases the power of government over American medicine.

Ronald Reagan had it right: “The nine most terrifying words in the English language are: I’m from the Government, and I’m here to help.”

Additional Background:

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