Over the past few weeks, there have been several developments regarding the No Surprises Act (NSA). First, in Congress, the No Surprises Act Enforcement Act (H.R. 9572) was introduced by Rep. Greg Murphy (R-NC), a member of the Doctors Caucus, to improve the enforcement of the NSA. Currently, while clinicians and hospitals face penalties for non-compliance, insurers often avoid such consequences. This bill aims to hold insurers accountable, with fines up to $10,000 per violation and additional penalties for late payments after Independent Dispute Resolution (IDR) decisions. The goal is to create fairness in the system, ensuring insurers comply with the law and reducing financial harm to patients.  

Another key development is the U.S. Department of Justice’s (DOJ) involvement in the Guardian Flight case, where it filed an amicus brief supporting the enforcement of IDR determinations in federal court. This move strengthens the government’s position on the importance of upholding the NSA’s protections, emphasizing the need for insurers to comply with IDR determinations. The DOJ’s stance could influence the future of H.R. 9572 and work towards bringing more accountability to health insurers.  

To explore these topics in more detail, listen to the latest episode of Zotec Answers, where Ed Gaines discusses how these changes could impact patient protection and healthcare.