The Partnership for Employer-Sponsored Coverage (P4ESC), an advocacy alliance representing businesses providing health coverage to millions of hardworking Americans and their families, joined labor unions and consumer groups in sending a letter to the Biden Administration urging that regulations being written to combat surprise medical billing follow congressional intent.

The No Surprises Act, which was comprehensive legislation to protect workers from surprise medical bills, was enacted in 2020. As written, the No Surprises Act prioritizes the qualified payment amount in the factors for consideration when parties seek settlement for a claims dispute through the law’s arbitration process. The stakeholder letter was sent to Health and Human Services Secretary Xavier Becerra, Treasury Secretary Janet Yellen and Labor Secretary Marty Walsh, whose departments are currently drafting the implementation regulations for the new law.

The letter notes: “Congressional intent can only be honored by drafting regulations that make the qualifying payment amount (QPA), on which patient cost-sharing is based, the primary factor in resolving payment disputes. The plain language of the statute requires that kind of a clear prioritization of factors that an arbiter may consider.” The stakeholders further states “[f]ailure to enact regulations that ensure the QPA is not inflated would mean higher out-of-pocket costs for millions of families in 2022 and beyond.”

P4ESC supports protecting patients when put in a situation in which they lack a choice of providers. The coalition has participated in discussions with the Tri-Departments and other stakeholders during the regulatory development phase and eagerly awaits release of the interim final rules.

The letter is available HERE.