In a letter to the editor, ACEP President L. Anthony Cirillo set the record straight on insurer bad behavior and the flawed implementation of the No Surprises Act:
“Focusing on outliers dangerously misrepresents the real threat facing patients: a nationwide practice of insurer underpayment that is destabilizing our emergency medicine safety net.
Emergency medicine comprises over a third of all arbitration cases — more than any other specialty — because insurers consistently underpay for unplanned care. The No Surprises Act protects patients from surprise medical bills, but insurer practices threaten access to care.
Emergency physicians’ high win rate in arbitration isn’t evidence of gaming the system; it’s proof of systemic underpayment. Professional, neutral arbiters repeatedly determine that insurers’ payments are insufficient. Yet even after losing more than 85 percent of the time, insurers then fail to pay nearly 60 percent of arbitration awards within statutory time frames. These costly delays push our emergency medicine system to a breaking point, risking longer wait times and closures.
The real story is that an insurance industry is profiting by underpaying for care. Congress must pass the No Surprises Enforcement Act to impose meaningful penalties for nonpayment and protect the financial viability of emergency care for all Americans.”
L. Anthony Cirillo
Saunderstown, R.I.
The writer is the President of the American College of Emergency Physicians.
Related Resources
