ACEP immediately launched an all-out blitz to push back against the flawed process put forth in the regulation. Find a full timeline of ACEP’s OON advocacy progress, plus links to the supporting documentation, at acep.org/surprise-billing, but here’s a quick breakdown of the latest push:

• Oct. 1: ACEP issues a statement strongly and publicly voicing our disappointment that the regulations are almost entirely inconsistent with Congressional intent to create a fair and unbiased process to resolve billing disputes.
• Oct. 14: ACEP hosts Surprise Billing Town Hall to update members on the second IFR and discuss advocacy strategy. • Oct. 15: ACEP and additional medical organizations meet with key federal leaders to discuss concerns about the second IFR.
• Nov. 5: Reps. Tom Suozzi (D-NY), Brad Wenstrup, DPM (R-OH), Raul Ruiz, MD (D-CA), and Larry Bucshon, MD (R-IN) send a letter to HHS urging them to amend the second interim final rule. ACEP members sent 5,297 messages to Congress asking them to support the letter, which was cosigned by 152 bipartisan members.
• Nov. 11: ACEP and EDPMA submit an initial response to the second interim final rule implementing the No Surprises Act, followed by a comprehensive response on Dec. 6.
• Dec. 9: ACEP publicly supports the goals of the lawsuit filed by the American Medical Association and the American Hospital Association against the Departments of Labor, Treasury, and Health and Human Services.
• 22: ACEP joined with the American College of Radiology and the American Society of Anesthesiologists to file a lawsuit against the government charging that the IFR goes against the language of the No Surprises Act and will ultimately harm patients and access to care.

“It is deeply troubling that the administration would up- end the deliberately balanced mechanism to resolve billing disputes established by Congress as part of the No Surprises Act. We are left with a law that will tilt market forces in favor of insurers and they are already exploiting their newfound incentive to push emergency physicians out of network,” ACEP President Gillian Schmitz, MD, FACEP, said. “Legal remedy is necessary so that the IFR does not undermine the entire dispute resolution process.”

This flawed IFR was issued without the customary comment period given to most federal regulations that allows organizations like ACEP to weigh in. Our lawsuit asks that the federal government be required to rescind the second IFR. This will compel the government to go start again, this time providing an opportunity for ACEP and other medical organizations to provide important feedback on the regulation.