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    November 17, 2021 

    The Honorable Janet Yellen
    U.S. Department of the Treasury
    1500 Pennsylvania Avenue, NW
    Washington, DC 20220

    The Honorable Martin Walsh
    U.S. Department of Labor
    200 Constitution Avenue, NW Washington, DC 20210

    The Honorable Xavier Becerra
    Secretary U.S. Department of Health and Human Services
    200 Independence Avenue, SW
    Washington, DC 20201

    Re: Concerns with Interim Final Rule Requirements Related to Surprise Billing: Part II implementing the No Surprises Act (NSA)

    Dear Secretaries, Becerra, Walsh, and Yellen:

    On behalf of the undersigned organizations representing physicians across the country, we write to urge you to reconsider the requirements in the Interim Final Rule (IFR), entitled “Requirements Related to Surprise Billing; Part II,” 86 Fed. Reg. 55,980 (Oct. 7, 2021), implementing the No Surprises Act (NSA) that directs Independent Dispute Resolution (IDR) entities to consider the qualifying payment amount (QPA) a rebuttable presumptive reasonable payment for out-of-network physicians engaging in the IDR process and, in turn, places a thumb on the scale in favor of health insurers in contract negotiations.


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