The Associations call on CMS to fairly rebalance the IDR process, keep administrative fees at fair and stable 2022 levels, and address their unsustainable backlog of claims under NSA. To ensure this appropriate and much needed reform at CMS, the Associations call on the new Congress to initiate oversight proceedings on these processes at CMS.
After first announcing in October 2022 that the 2023 administrative fee would remain stable, in a last-minute move in late December 2022, CMS announced a 600% increase in non-refundable administrative fees for any party to file out-of-network claims disputes through the NSA's IDR process. Additionally, CMS had previously announced fee increases of up to 117% for IDR entities. The dramatic, unprecedented increase in initial fees with less than a week's notice disproportionately affects providers, favors health plans, and will hurt consumers.
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About RBMA:
The Radiology Business Management Association (RBMA) is an industry-leading organization comprised of more than 2,100 professionals who focus on the business of radiology. RBMA members support diagnostic imaging, interventional radiology and radiation oncology providers in the full spectrum of practice settings. RBMA connects members nationwide to valuable information, education, and practice-related resources and serves as an authoritative industry voice on behalf of shared member interests.
About EDPMA:
The Emergency Department Practice Management Association (EDPMA) is the nation's largest professional physician trade association focused on the delivery of high-quality, cost-effective care in the emergency department. EDPMA's membership includes emergency medicine physician groups of all sizes, as well as billing, coding, and other professional support organizations that assist healthcare providers in our nation's emergency departments. Together, EDPMA's members deliver (or directly support) health care for about half of the 146 million patients that visit U.S. emergency departments each year.
About HBMA:
The Healthcare Business Management Association (HBMA), a non-profit professional trade association, is a major voice in the revenue cycle management industry in the United States. HBMA is a recognized revenue cycle management (RCM) authority by both the commercial insurance industry and the governmental agencies that regulate or otherwise affect the U.S. healthcare system. To learn more, visit www.hbma.org.
About MGMA:
Founded in 1926, the Medical Group Management Association (MGMA) is the nation's largest association focused on the business of medical practice management. MGMA consists of 15,000 group medical practices ranging from small private medical practices to large national health systems representing more than 350,000 physicians. MGMA helps nearly 60,000 medical practice leaders and the healthcare community solve the business challenges of running practices so that they can focus on providing outstanding patient care. Specifically, MGMA helps its members innovate and improve profitability and financial sustainability, and it provides the gold standard on industry benchmarks such as physician compensation. The association also advocates extensively on its members' behalf on national regulatory and policy issues. To learn more, go to MGMA.com or follow us on LinkedIn, Twitter and Facebook.
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