Radiology groups air No Surprises Act grievances to CMS chief of staff

Radiology groups told CMS chief of staff that some insurers propose in-network rates 21% below market, driving costly arbitration. CMS acknowledges enforcement gaps, vows priority action, as appeals court nixes ‘ghost rates’ for qualifying payment amounts.

• The American College of Radiology, Zotec Partners, and Strategic Radiology met with CMS Chief of Staff Rebekah Armstrong to highlight insurer tactics under the No Surprises Act.
• Radiology Associates of North Texas reported that a large Texas payer consistently refused meaningful negotiation and offered rates 21% below market, forcing out-of-network status and arbitration.
• A recent appeals court ruling invalidated the use of ‘ghost rates’ in qualifying payment amount calculations, a decision ACR called a win for the specialty.

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