No Surprises Act
As a result of the 2021 Consolidated Appropriations Act, several No Surprises Billing Act regulations will go into effect on Jan. 1, 2022 for providers, facilities and air ambulance services.
HFMA has made it a priority to work closely with stakeholders, industry partners and members to help them navigate and prepare for the No Surprises Act regulations that will continue to be phased in throughout 2022 and beyond.
Join the No Surprises Act Forum to connect with peers, exchange resources and discuss implementation challenges.
Recent Community Discussions for No Surprise Billing Act:
- Requiring prior authorizations before OON patient scheduling
- Centralized price estimates department
- GFE exclusions for cosmetic procedures
- How is a skilled nursing facility affected by the NSA?
- Including the diagnosis code on GFE letters
- Out-of-network quotes
- Referenced based pricing and NSA
- Out-of-network guidance and enforcement
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
Federal judge rules for providers in a case about a key component of the new surprise billing regulations
A federal judge found in favor of the Texas Medical Association in a case about the arbitration process that is being implemented as part of the No Surprises Act.
New surprise billing regulations: Assessing a patient’s network status will be a key challenge
With new surprise billing regulations in place, providers should seek to implement efficient processes for gauging whether a patient is in-network.
Senate panel discusses ways to address Medicare financing — and the consequences of not acting
Medicare Part D and Medicare Advantage could be prime targets as Congress seeks to shore up the Hospital Insurance Trust Fund before it becomes insolvent in 2026 as projected.
Shawn Stack: No Surprises Act is important move toward meaningful consumer transparency
The No Surprises Act, which became effective on Jan. 1 of 2022, will clearly benefit patients, .ut its larger impact is yet to be seen as the industry awaits the release of provisions targeting health plans and payers.
HHS’s Office of Inspector General announces audit of providers’ COVID-19 billing practices
OIG has announced an audit of Provider Relief Fund recipients to ensure they did not balance-bill presumptive or actual COVID-19 patients.
New surprise billing regulations: How providers should be preparing to fulfill the pending requirement about good-faith estimates
Providers have had a mere three months to implement the processes needed to comply with a new requirement to provide uninsured patients with good-faith estimates in advance of services.
Hospitals, physicians file lawsuit over the arbitration process in the new surprise billing regulations
Leading provider associations have asked a federal court to halt the incorporation of criteria that appear to favor insurers over providers in an arbitration process to determine out-of-network payment amounts.
CMS makes templates available to help with aspects of the new surprise billing regulations
CMS has published templates and resources that can guide healthcare providers in implementing some of the surprise-billing requirements that take effect in January.
A closer look at the new surprise billing regulations: How cost sharing will be calculated
The qualifying payment amount that establishes a patient's cost sharing for out-of-network care also is intended to factor into negotiations between providers and health plans regarding payment.
The finalized arbitration process in new surprise-billing regulations appears to favor insurers over hospitals
A new rule establishes a process for resolving payment disputes between health plans and hospitals when regulations on surprise billing begin in 2022.
Government agencies issue the first set of regulations restricting surprise billing
In a development that many healthcare stakeholders have awaited for months, four federal agencies on Thursday, July 1 released new regulations prohibiting surprise billing in many scenarios.
Healthcare providers face challenges implementing the latest Surprise Medical Billing Interim Final Rule
HFMA’s Shawn Stack reviews the key provider challenges introduced by the IFC interim final rule with comment period (IFC) that implements sections of the federal ban on surprise medical bills.
CMS Principal Deputy Administrator Jonathan Blum discusses price transparency, surprise billing and the future of value-based payment
HFMA President and CEO Joe Fifer interviews Jonathan Blum, principal deputy administrator and COO at CMS. In this interview, Blum discusses how CMS plans to phase out the public health emergency, how price transparency and surprise billing legislation are being received by provider organizations, and the effect the pandemic will have on CMS's value-based care strategy.
Patients have access to more information than ever. How should we be talking to them about it?
The Information Blocking Final Rule from the 21st Century Cures Act and federal transparency initiatives like the No Surprises Act have given patients more access to information than they’ve ever had before. On this episode, Terry Hush, CEO of Roji Health Intelligence, discussed how that access should change the conversations providers are having with their patients.
How providers should prepare for No Surprises deadlines
Nick Hut talks with John Friedel from Abeo about the No Surprises Act and what providers should be doing now to prepare.