Amicus Brief Filed in Support of Lawsuit Challenging No Surprises Act Rule

    The Physicians Advocacy Institute; 9 national medical societies, including the American Association of Orthopaedic Surgeons (AAOS); and 16 state medical societies and have jointly filed an amicus brief supporting a lawsuit led by the American Medical Association and American Hospital Association that challenges the federal government’s implementation of the No Surprises Act.

    The brief warns that the administrative rules for implementation of the law, which took effect on January 1, “bluntly undercut” carefully crafted legislation and will greatly diminish patient access to care.

    “It quite literally took an act of Congress and years of tireless advocacy to determine a fair solution to this problem that has been plaguing patients for years, only to have those efforts squandered by these reckless regulations,” said AAOS President Daniel K. Guy, MD, FAAOS.

    “In turning to legal action, we remain committed to protecting patients from the heavy-hand of insurers and ensuring that the imbalance of power in good faith negotiations over payment disputes is not further exacerbated.”

    The amicus brief argues that regulators overstepped their rulemaking authority and acted directly in contrast to the statutory requirements and purpose of the No Surprises Act. It then details how the insurer-determined rate for out-of-network reimbursement will impact patient access to care and disrupt free market forces that have served to check health insurers’ overreach.

    AAOS previously submitted formal comments to regulators in response to the Requirements Related to Surprise Billing Part II Interim Final Rule. As in the amicus brief, AAOS warned that unsustainable reimbursements, coupled with severe financial losses during the COVID-19 pandemic, will only accelerate the significant financial pressures that have forced many physician practices to consolidate.

    The brief notes that research proves physician workforce consolidation raises prices and increases overall healthcare spending without clear indications of quality improvements. It also undermines choice and continuity of care, ultimately raising the out-of-pocket costs that must be borne by patients.