The Emergency Department Practice Management Association (EDPMA) has released data dissecting compliance and other metrics surrounding the No Surprises Act (NSA) since it was first implemented in January 2022. Since its implementation, there have been occasions where the rules have been revised, with the goal of enforcement and compliance.  

EDPMA produced data for the 2022 calendar year, and now has released data from the 2023 calendar year. Findings show that emergency physicians experienced a 39 percent decline in out-of-network (OON) reimbursement when comparing 2023 to 2022. This is a significant reduction in OON reimbursement when compared to the prior year. This decline is on top of the Medicare physician fee schedule (MPFS) cut physicians saw this year and the lack of inflationary updates to the MPFS.  

This report contains many additional findings, including overall non-compliance rates compared to the previous year and how health plans have been shifting their financial liability after losing IDRE determination to the patient, increasing patient costs. To learn more about these findings and the report, listen to our latest episode of Zotec Answers where Ed Gaines breaks down the report.