Legal and Regulatory Compliance

No Surprises Act

May 18, 2022 9:42 pm

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.

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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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