The No Surprises Act has got everyone talking these days. From the word go, there has been a feeling in the air ambulance industry that the regulation is going to go against it. Now, industry experts believe that the fear is turning into a reality.
The intent of the No Surprises Act is excellent. In that, it plans to exclude the patient from the picture when a payment dispute arises. In other words, when an insurance company refuses to cover the air ambulance cost in full, the burden of balance payments does not fall on the patient. It is for the insurance company and the air ambulance service provider to settle the financial differences between themselves.
The Air Ambulance Association Cites Problem with IDR
IDR stands for independent dispute resolution. It has been drafted such that insurance providers and healthcare providers (including air ambulance service providers) can hold discussions between themselves and come to a conclusion on payments. If not, they are free to approach an independent entity as defined by the No Surprises Act. However, one of the clauses set by Congress says that no single statutory factor must veer in any direction during IDR. However, the air ambulance association felt that the federal government was weighing heavily on a single factor and that is qualified payment amount or QPA.
The air ambulance association is of the opinion that the impetus solely on QPA will have disastrous consequences for the industry and also the people that it caters to. If the insurance providers are the sole authority on the payments that are to be made for medical flight services, it may prove detrimental to the industry. Ultimately, it will act as a disincentive to the air ambulance business. Many air ambulance service providers may be forced to shut their businesses.