"It obviously got a lot of provider groups mad, but….

...this is basically the framework most arbitrators would have come to naturally. Fundamentally, you need some starting price that is effectively your presumption of what the fair or appropriate out-of-network price is."

— Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, talked with AIS's Health Plan Weekly about the latest update to the No Surprises Act, which requires arbitrators to use QPAs to settle disputed out-of-network claims.

 

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