Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Out of Network Balance Billing

Provider Directory Requirements of the No Surprises Act

Among the lesser known provisions of the No Surprises Act are those that seek to improve the accuracy of in-network provider directories maintained by insurance plans. While more complete rulemaking to address provider directories is expected later in 2022, the No Surprises Act laid out the general groundwork for both payers and providers to tackle the problem of out-of-date and inaccurate directories. The law also includes some protection for patients who rely on bad information in a directory and end up with a surprise out-of-network bill. READ MORE

Judge Orders Changes to the Independent Dispute Resolution Process

A February ruling by Judge Jeremy D. Kernodle in the U.S. District Court for the Eastern District of Texas found portions of the independent dispute resolution process, established by the Departments of Health and Human Services, Labor, and Treasury during last year’s surprise billing rulemaking, to be inconsistent with the No Surprises Act. READ MORE

Payers, Providers Seek Delay for No Surprises Act Implementation, HHS Offers Some Relief

Both payers and providers are seeking some relief on the quick turn-around of the No Surprises Act, which is supposed to become effective January 1, 2022. And with the recent announcement of delays to certain portions of the Interim Final Rules implementing the surprise billing provisions of the act, it seems like the Biden administration is listening. READ MORE

Surprise Billing Interim Final Rule: What You Should Know

Earlier this month, healthcare providers and insurance plans got a more detailed look at how the No Surprises Act (NSA) will be implemented when the departments of Health and Human Services (HHS), Labor, and Treasury released a 411-page interim final rule that will go into effect on January 1, 2022. READ MORE

Planning Ahead for No Surprises Act Implementation

The No Surprises Act, which was signed into law in December 2020, won’t go into effect until at least January 1, 2022. But that isn’t slowing down provider groups from working to ensure the details of the bill, which will be administered through by agencies like the Departments of Health and Human Services, Labor, and Treasury, are ironed out with their interests in mind. READ MORE

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