Senator slams HHS' implementation of No Surprises Act as 'big mess' after legal battles

Senators are calling for the Biden administration to do better to implement a law that bans surprise medical bills, lamenting hiccups with setting up an arbitration dispute process on out-of-network charges. 

“It’s a big mess,” said Sen. Michael Bennet, D-Colorado, during a budget hearing Wednesday in the Senate Finance Committee. “CMS has frozen and unfrozen the process over the last few months.”

Bennet sought answers from Department of Health and Human Services (HHS) Secretary Xavier Becerra who testified at the hearing Wednesday. The queries come as the administration recently resumed arbitration disputes between payers and providers to settle out-of-network charge feuds.

The process where a third-party arbiter chooses a preferred amount between payers and providers has been a major flashpoint in the implementation of the No Surprises Act, a 2020 law that bans surprise medical bills. 

HHS resumed arbitration disputes late last week after the agency paused the determinations following a legal ruling that struck down parts of the process. 

Becerra responded that his agency has been completely overwhelmed by a deluge of claims for arbitration.

“We are receiving more than 10 times the number of claims than anyone ever expected,” he said. “These arbitrators are swamped.”

Becerra added that most of the disputes appear to be frivolous because there is no cost to submit a claim for arbitration. 

Congress recently gave HHS more funding to hire more people to handle the arbitration process, but Becerra pled with lawmakers for more help.

The exchange comes as HHS remains in a legal battle with providers surrounding the implementation of the independent dispute resolution process.

The Texas Medical Association (TMA) has filed several lawsuits arguing that HHS has gone against congressional intent when implementing the arbitration process amid other issues. The TMA has argued that the regulations implementing the law called for the arbiter to put too much weight on the qualifying payment amount, which is the average geographic rate for a service. 

HHS temporarily paused arbitration dispute resolutions after a federal judge sided with TMA on the legality of a rule outlining the process.