Policy & Enforcement

ACEP shares insurer participation analysis with Congress

Source: American College of Emergency Physicians · September 22, 2026

ACEP, ACR, and ASA sent Congress an analysis arguing that insurer payment practices and nonparticipation contribute to federal IDR disputes.

Reported Details

In its September 22 statement, ACEP says the societies’ analysis of CMS data found that insurers lost by default on 24.5% of IDR line items in 2025. Offers of $1 or less accounted for 8.2% of line items; excluding defaults, nearly 40% of insurer offers were at or below the qualifying payment amount (QPA). The societies call for stronger enforcement of insurer obligations and congressional scrutiny of repeated defaults, extreme offers, and QPA calculations. They also urge Congress to preserve the existing IDR framework. These are the societies’ findings and policy requests, not newly enacted requirements.