The California Medical Association (CMA) is urging Congress to strengthen enforcement of the No Surprises Act (NSA), a federal law designed to protect patients from surprise medical bills and resolve payments disputes between health plans and physicians through an independent dispute resolution (IDR) arbitration process.

CMA has joined the American Medical Association and others in organized medicine to support the Enhanced Enforcement of Health Coverage Act (HR 9572). Introduced by  Reps. Greg Murphy, M.D. (R-NC), Jimmy Panetta (D-CA), Raul Ruiz, M.D. (D-CA), John Joyce, M.D. (R-PA) and Kim Schrier, M.D. (D-WA), HR 9572 would strengthen the NSA by closing loopholes and increasing penalties for health plans that violate balance billing requirements and fail to comply with the law’s timely payment provisions.

Currently, Insurers are failing to comply with the NSA’s timely payment provisions, with more than 50% of payments owed physicians after IDR determinations being late or unpaid, despite recent reforms that simplified the payment process. Insurer’s failure to pay is causing serious financial hardship and instability for physician practices.   Health plans are routinely denying coverage for care protected by the NSA and are illegally changing the patient cost-sharing amounts after IDR determinations have been made – in some cases unlawfully billing patients for the full amount of the services provided.

CMA urges Congress to quickly pass HR 9572 to solidify the NSA’s protections for patients and to ensure the law is providing a fair and balanced IDR process for physicians. If left unchecked, insurers will continue to undermine the bipartisan goals of the NSA and erode the stability of physician practices and access to care across the U.S. health system.