Tag: Balance Billing

No Surprises Act Implementation

FAQ on No Surprises Act Implementation and Requirements

CMS Releases FAQ for No Surprises Act Implementation, Requirements The No Surprises Act FAQ states that balance billing protections do not apply to individuals with public healthcare coverage and notice and consent forms must be provided and received in written format. June 28, 2022 – CMS has released Frequently Asked Questions (FAQs) on the No […]
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CMS Releases No Surprises Act State Enforcement Letters

During a National Stakeholder Call on January 18, 2022, Ellen Montz—Deputy Administrator and Director of the Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS)—announced that CMS had begun publishing state-specific letters (the “Enforcement Letters”) detailing anticipated Federal and state responsibilities with respect to enforcement of the […]
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Physicians Collect More From Surprise Medical Bills in ED

Physicians in a hospital’s emergency department (ED) collected significantly more of the charged amount for likely surprise medical bills compared to other patient cases, a new study in Health Affairs reveals. In the event of a likely surprise medical bill, physicians collected 65 percent of the charged amount compared with just 52 percent for other cases. Researchers also found […]
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Key Ways Providers Can Prepare for New Surprise Billing Rules

Starting January 1, 2022, healthcare providers will be subject to a new surprise billing law that makes it illegal for providers to bill patients more than in-network cost-sharing for out-of-network services and establishes an arbitration process to resolve unexpected out-of-network charges. The law, the No Surprises Act, was passed in December 2020 as part of […]
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Congress Takes Steps to Curb Unexpected Medical Bills

Most Americans tell pollsters they’re worried about being able to afford an unexpected medical bill. Late Monday, Congress passed a bill to allay some of those fears. The measure is included in a nearly 5,600-page package providing coronavirus economic relief and government funding for the rest of the fiscal year. Specifically, the legislation addresses those […]
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Providers, Insurers Parse What They Could Support – And What They Won’t – In Surprise Billing Solution

While both providers and insurers have found it difficult to agree on a solution to surprise billing, experts on both sides expressed support Tuesday for banning the practice – thereby forcing insurers and providers to work out payment disputes among themselves—when patients have gone to in-network hospitals. The approach, which has been tried in Oregon, […]
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