The American College of Radiology is gravely disappointed with the fed planning to calculate its qualifying payments under the newly unveiled regulation to address all surprise bills for medical purposes.
In a recent release, the Health and Human Services disclosed a 411-page rule, starting the process of acknowledging and addressing the issue immediately after Congress passes its legislation last December. To determine whether the provider payments are qualifying under this rule, this college was concerned about the rule lacking nuances in the way it addresses varied provider groups.
The news updated that, “the ACR has been disappointed with certain aspects of the method of calculation of the qualifying amount of payment, including treatment of provider contracts evenly irrespective of the size of the practice and the market share of providers while determining the rate of the median. For instance, the rate contracted for a practice involving 25 radiologists serving 80 percent of this market is considered the same as the contracts with 3 radiologists serving 5 percent of the same market.” In addition, ACR also argued that the method of incentive-based payments also should be factored into this calculation of the median rates.
In May 2021, the ACR also asserted its unconditional support to the No Surprises Act and the drive to maintain patients out of the disputes involving reimbursement. However, the same group also highlighted the importance of fixing holes in this legislation to ensure sufficient reimbursement for services that remain out-of-network. In a new analysis, famous radiologists expressed that the No Surprises Act could have a significant impact on the current radiology practices, which includes those that do not practice billing out-of-network balance.
Moreover, ACR also released a detailed report of the final rule (interim) on July 8 and further revealed that it would submit its comments to the Health and Human Services soon. The feds also plan to soon implement this legislation within January 1, 2022.
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