Court Agrees With Physicians’ Argument in Federal No Surprises Act Rule Case
Statement by Gary W. Floyd, MD, Texas Medical Association (TMA) president, in response to the U.S. District Court for the Eastern District of Texas ruling on TMA’s motion for summary judgment in its lawsuit opposing certain components of federal regulatory agencies’ final rules regarding dispute resolution under the No Surprises Act. TMA argued the case in the U.S. District Court in December, addressing the second of four TMA lawsuits against federal agencies related to rulemaking under the surprise-billing arbitration law.
“TMA is pleased the court granted its motion for summary judgment in its lawsuit challenging certain components of the federal agencies’ final rules relating to the federal independent dispute resolution (IDR) process under the No Surprises Act. This is an important next step after TMA successfully challenged an interim final rule that similarly skewed the IDR process in health plans’ favor.
“This decision is a major victory for patients and physicians. It also is a reminder that federal agencies must adopt regulations in accordance with the law.
“The decision will promote patients’ access to quality care when they need it most and help guard against health insurer business practices that give patients fewer choices of affordable in-network physicians and threaten the sustainability of physician practices.”
TMA is the largest state medical society in the nation, representing more than 57,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.
This article was originally published in the September/October 2022 issue of the Tarrant County Physician. You can read find the full magazine here.
Over the past year, the Texas Medical Association has had to weigh in on one sensitivetopic after another—from issues impacting the patient-physician relationship to how physicians practice medicine and the prevention of further cuts in the Medicare program.
Often, after TMA publishes its stance in the association’s daily newsletter, Texas Medicine Today, we receive inquiries from members on how TMA came up with that position since no one surveyed them individually or asked for their opinion. This has made me realize many of our members don’t understand who runs TMA or the process TMA uses to develop its policy, which drives the association’s communications and advocacy.
The association is governed by a 500-member House of Delegates, the legislative and policymaking body. The House is made up of elected county medical society delegates (one delegate per 100 members or fraction thereof) and the following ex officio members: members of the Board of Trustees; 15 councilors; Texas delegates and alternate delegates to the American Medical Association; members of the Council on Legislation and chairs of the other councils; delegates from the Young Physician Section, International Medical Graduate Section, Resident and Fellow Section, Women Physician Section, LGBTQ Section, and Medical Student Section; and delegates of selected specialty societies.
The House of Delegates meets every year at an annual session held during TexMed in the spring. In 2023, TexMed will be in Fort Worth on May 19–20.
The best way to get your idea adopted as TMA policy is to begin at the grassroots level.
1 Present your idea or change to an existing policy at your county medical society meeting. Ideas and actions also are developed by association boards, councils, committees, and sections. You can work with these groups to develop a policy recommendation.
2 If the county society, section, or other entity agrees, it can submit your idea as a report or resolution to be considered at the next meeting of the House of Delegates. Instructions for writing a resolution are at http://www.texmed.org/Resolution.
3 Every report and resolution is assigned to a reference committee that vets it further through open hearings at which any TMA member can testify. The reference committees then send their recommendations on each report and resolution to the house. If you would like to serve on a reference committee, let our House of Delegates speakers know by filling out the form at tma.tips/refcom.
4 If your idea is adopted by the house, it is incorporated into the TMA Policy Compendium (www.texmed.org/Policy). If it has nationwide appeal, it may also be forwarded to AMA for action.
As TMA president, I am obliged to represent our TMA policies. As you can imagine, we have members on both sides of several very sensitive issues. Some members would like TMA to issue an immediate, strong opinion favoring their stance. However, by working with our legislators, we have learned that calm, measured, commonsense approaches are far better received than knee-jerk responses. Therefore, in our responses we tend to emphasize areas of commonality for our members, like protecting the sanctity and privacy of our patient-physician relationships and creating a safe environment for our physicians to exercise their best medical judgment in providing the appropriate standard of care for all their patients.
Please reach out to your county medical society and learn more about TMA’s policymaking process. We want to hear from you!
As part of their “Conversation With” series, which highlights leaders in the North Texas community, D CEO Healthcare sat down with TMA President Dr. Gary Floyd to discuss a range of topics – from restoring trust in medicine to transgender care and legislative priorities. Here’s an excerpt:
“When the public health emergency is declared over, over a million people will lose coverage in Texas. We’ve been trying to work with our legislators about targeted plans to extend coverage. We would like to continue to cover children from birth through six months and expand it to have 12 months of eligibility; We would like to cover pregnant moms postpartum for 12 months. We are trying to improve payment for delivering Medicaid services that haven’t been changed in over 20 years.”
Tarrant County Physician Online 