Physicians Advocacy Institute
On September 18, 2023, the Physicians Advocacy Institute filed an amicus curiae brief in the United States Court of Appeals for the Fifth Circuit, supporting the Texas Medical Association’s (TMA) challenge to the No Surprises Act’s independent dispute resolution (IDR) process. PAI is joined on the brief by 16 state medical associations and seven medical specialty societies.
At issue in the TMA case, and the subject of PAI’s brief, is how the government’s final rule governing the IDR process wrongly encouraged arbitrators to weigh the qualifying payment amount (QPA) more heavily than other factors that are supposed to be considered when arbitrators decide payment disputes between insurers and physicians under the No Surprises Act.
In January 2023, United States District Court for the Eastern District of Texas Judge Jeremy D. Kernodle ruled in TMA’s favor, vacating federal agencies’ August 2022 final rule that unduly tilted the No Surprises Act’s IDR process in favor of big health insurance companies. The Administration subsequently appealed the decision.
Physicians are strong supporters of the No Surprises Act. PAI continues to advocate for a fair IDR process that is consistent with the intent of Congress, is fair to both insurers and physicians and does not jeopardize patient care.
Access the PAI Amicus Curiae Brief and Press Release here.