AMA-AHA surprise billing lawsuit dropped

The American Hospital Association and the American Medical Association have ended one legal challenge to the federal surprise billing arbitration process but have plans to try again, the organizations announced Tuesday.

“We have serious concerns that the August 2022 final rule departs from congressional intent just as the September 2021 interim final rule did. Hospitals and doctors intend to make our voices heard in the courts very soon about these continued problems,” the AHA and AMA said in a joint statement. 

The AHA and AMA’s fellow plaintiffs–UMass Memorial Health Care of Worcester, Massachusetts, Renown Health of Reno, Nevada, Dr. Stuart Squires and Dr. Victor Kubit–also dismissed their claims against the government. 

The two healthcare associations filed a lawsuit against the federal government in December, contending the surprise billing arbitration process would harm providers by leading to underpayment for out-of-network services. The interim regulation required arbiters to pick the offer closest to the insurer’s median contracted in-network rate.

In February, the U.S. District Court for the Eastern District of Texas ruled in favor of providers in a separate lawsuit over the arbitration process. The decision is reflected in regulators’ final rule on the process, which requires that arbiters consider both an insurer’s median contracted in-network rate and additional information when deciding the payment for a surprise bill. 

The AMA and AHA’s current lawsuit is moot after regulators released a final rule on the surprise billing arbitration process in August, an AHA spokesperson said.

Still, providers aren’t happy with the final rule, and plan additional legal action over the arbitration process. The AHA and AMA did not respond when asked their specific concerns. 

The AMA and AHA’s lawsuit was consolidated with a complaint from the Association of Air Medical Services over the same process in February. The Association of Air Medical Services is not listed as one of the plaintiffs dismissing their claims Tuesday and did not respond to a request for comment. 

The parties are scheduled to have a status hearing before Judge Richard Leon of the U.S. District Court for the District of Columbia on Wednesday.