Tag: No Surprises Act

Uninsured-Consumers-Protected-From-Surprise-Bills

Uninsured Consumers Also Protected From High Surprise Bills

Most providers understand the “No Surprises” requirements for insured patients. Effective as of Jan. 1, 2022, uninsured (or self-pay) consumers are also protected from unexpected high medical bills. If a consumer doesn’t have health insurance or doesn’t plan to use insurance to pay for health care items or services, they must be given a “good […]
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Unpleasant-Surprises-From-No-Surprises-Act

Unpleasant Surprises Stemming From The No Surprises Act

One facility recently found that failing to get an estimate to a patient in timely fashion created more than a few headaches. This past January, immediately after the good-faith price estimate requirement for hospitals went into effect, one of my clients received a call from a patient late on a Friday to schedule a procedure […]
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No-Surprises-Act-Compliance-as-a-New-Burden

No Surprises Act Compliance Debuted as a New Burden

Regulatory burden is on the rise yet again as practices struggle with prior authorizations, No Surprises Act compliance, and the Quality Payment Program, MGMA reports. Prior authorizations are still the top regulatory burden according to executives from group practices, while No Surprises Act compliance has debuted on the list this year as the second most […]
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No-Surprises-Act-More-to-Come

More Versions to Come: No Surprises Act

Although the Biden Administration claims this is the final regulation, there is evidence more is yet to come. The Biden administration released the final No Surprises Act regulation recently but advised healthcare professionals that this final version is not the final one and promised more to come. The latest final rule was narrowly focused on […]
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Final Surprise Billing Rules QPA

Biden Administration Releases Final Surprise Billing Rules

The final surprise billing rules downgrade the weight the QPA has on out-of-network payment determinations and establishes documentation requirements for down coding situations. The Biden Administration has released final surprise billing rules implementing the No Surprises Act, a federal law enacted in January 2021 that protects patients from out-of-network medical bills when they seek care […]
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Medicare-Physician-Payments-picture

Where did all the Medicare Physician Payments Go

The federal government probably won’t be raising Medicare reimbursements next year, and physician organizations are strongly objecting. At its Jan. 13 meeting, the Medicare Payment Advisory Commission (MedPAC), which advises Congress on financial issues pertaining to Medicare, recommended against increasing base payment rates to doctors in 2023. It justified its decision in part by noting […]
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No Surprises Act May Have Blocked 2M Surprise Billing Claims | AllZone Management Services Inc.

No Surprises Act May Have Blocked 2M Surprise Billing Claims

The No Surprises Act came into effect in December 2021, potentially averting countless instances of unexpected billing claims within its initial two months of implementation. By May 24, 2022, the No Surprises Act had already thwarted over two million cases of surprise billing claims during its initial two-month span, as per a survey conducted by […]
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HHS requests a hold on its surprise billing appeal

After appealing the courts’ ruling on vacating a piece of arbitration within the No Surprises Act, HHS asks the court for a hold on its plea. HHS recently requested for a hold on its appeal of a Texas federal court ruling vacating parts of the independent dispute resolution (IDR) process in the surprise billing interim […]
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