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Blog Post, Multimedia
Ending the Public Health Emergency - Medicaid Updates
April 14, 2023
Watch the recording from week two of our Ending the Public Health Emergency webinar series!
Brennan Manna Diamond
No Surprises Act Update: The IDR Portal is Open
April 25, 2022
The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.
Ashley Watson, Daphne Kackloudis, and Jordan Burdick
Updated FAQs for the No Surprises Act - Good Faith Estimates
April 7, 2022
The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.
Daphne Kackloudis and Ashley Watson
No Surprises Act Compliance (Published by NAMAS, 2/25/22)
March 7, 2022
The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.
No Surprises Act and You (Published in the SCMS Winter 2022 Newsletter)
March 3, 2022
Legislation has been adopted by the United States Congress and the Ohio Legislature known as the “No Surprises Act” which attempts to regulate billing by professionals and facilities to patients who are not in networks with those facilities or providers at those facilities. The federal bill was triggered by some sensational news stories of patients being billed for tens of thousands of dollars for emergency care when the hospital was out of the network under the patient’s insurance plans.
Scott P. Sandrock
No Surprises Act Update: Federal Judge Strikes Portions of the No Surprises Act
February 25, 2022
In a win for providers, a Texas federal court granted the Texas Medical Association’s (TMA) motion for summary judgment and struck down portions of a federal rule that establishes a reimbursement rate arbitration process between payors and providers under the No Surprises Act (NSA).
Daphne Kackloudis, Ashley Watson, and Jordan Burdick
Federal and Ohio Laws on Surprise Billing
January 18, 2022
Beginning in January 2022, Ohio providers and healthcare facilities will need to comply with both the federal No Surprises Act (“NSA”) and the state surprise billing law (HB 388), which are both designed to protect patients from unexpected medical bills.
Ashley Watson and Daphne Kackloudis