CHA News

CMS Releases Additional Guidance Related to No Surprises Act Implementation for Uninsured Patients

For CEOs, CFOs, government relations executives, finance & reimbursement staff, legal counsel

The Centers for Medicare & Medicaid Services (CMS) has released additional resources to help facilities and providers deliver good faith estimates (GFEs) to uninsured/self-pay patients as required by the No Surprises Act (NSA). This requirement became effective Jan. 1, 2022. 

The resources include additional guidance on the independent dispute resolution (IDR) process, related FAQs, and a list of IDR entities. A description of each and links to the related material are included below. CHA encourages members to share these resources with the teams within their organization who are responsible for implementing the processes necessary to comply with the NSA.  

  • Guidance on Uninsured/Self-Pay GFEs and the Patient Provider Dispute Resolution Process: The document summarizes the key requirements from the interim final rules related to the provision of GFEs to uninsured/self-pay individuals and the patient provider dispute resolution process (PPDR). It includes several examples of both the GFE and PPDR process starting on pages 10 and 13. A timeline of steps included in the PPDR process can be found on page 21. 
  • GFE FAQs: CMS has provided FAQs for the Self-Pay/Uninsured GFE requirement; they will be updated by the agency periodically.  
  • CHA Resources: Available online, these resources help members understand and comply with the NSA’s requirements.