So far, EDPMA filed an amicus brief in three cases challenging the No Surprises Act rule implementing the independent dispute resolution process. Here is a related press release.
EDPMA has filed an amicus brief in a lawsuit filed in Texas by the Texas Medical Association, in the District of Columbia by the American Medical Association and American Hospital Association, and in Georgia by Georgia ACEP. EDPMA also plans to file an amicus brief in Illinois in the suit filed by ACEP.
On January 7, 2022, EDPMA urged the Administration to provide a more thorough accounting of the COVID-19 Provider Relief Funds to better understand how remaining funds may be dispersed: 1/7/22 EDPMA letter to HHS on PRF Accounting.
The Summary of EDPMA’s Advocacy Successes in 2021 can be found here.
Urge Congress to Eliminate or Delay Scheduled Cuts to Medicare Physician Reimbursement
This week the House of Representatives is likely to consider legislation that will address some of the 9.75% cut to Medicare provider reimbursement that is scheduled to take effect in January 2022. The Senate will likely consider legislation soon thereafter. We urge you to reach out to your congressional delegation and ask them to support legislation that will eliminate or delay the scheduled Medicare cuts.
You can identify your member of the House and find their contact information by visiting www.house.gov and typing your zip code in the upper right corner. You can identify your two senators and find their contact information by visiting www.senate.gov and searching by senators by state. Since the vote is imminent, we recommend making these three phone calls and leaving your message with the person who answers the phone.
Get the background and talking points you need here.
On November 29 EDPMA and a coalition of providers continue to push Congress to stop the impending 9.75% cut to Medicare reimbursement: 11/29/21 EDPMA/Coalition Letter on Medicare Cuts.
The form to submit a proposal you would like to present at the 2022 EDPMA Solutions Summit is now open! As experts in the business of emergency medicine, we hope that you are interested in presenting at the 2022 Solutions Summit on April 24-27, 2022 in Amelia Island, Florida. If you are interested, we’d like to receive your application. EDPMA also encourages you to share this link with coworkers and industry colleagues you think would be great speakers on issues facing the business of emergency medicine.
Don’t forget, all applications must be completed in full and received by December 5, 2021 and submitted through the link below, which includes the application questions.
Submit Your Proposal
On October 1, 2021, EDPMA and others blasted the Interim Final Rule that contradicts both the intent and language of the No Surprises Act (NSA) in a windfall for profitable commercial insurers which threatens patient access to care. Early versions of the NSA — which could not pass due to lack of Congressional support — tied out-of-network reimbursement to the plan’s in-network rate. In order to garner enough Congressional support to pass the bill, the bill was amended to include a list of factors the arbiter may consider and a list of factors the arbiter may not consider. The rule released on September 30th directs arbiters to ignore these lists and simply choose the payment amount that is closest to the plan’s in-network rate in most cases. Moreover, the rules provide that the plan’s in-network rate (also known as the Qualifying Payment Amount (QPA)) should not reflect any bonus payments or other related compensation earned by providers.
On September 13, 2021, EDPMA commented on the Proposed 2022 Medicare Physician Fee Schedule. Read the full letter below.
9/13/21 EDPMA Comment Letter on Proposed 2022 Medicare Physician Fee Schedule.
On August 31, 2021, EDPMA and ACEP urged Cigna not to implement its policy of down coding based on diagnosis because it violates the Prudent Layperson Standard and coding standards. See the letter below
8/30/21 EDPMA Letter to Cigna re: Down Coding