Independent Dispute Resolution Entities Instructed to Hold All Payment Determinations
The Centers for Medicare & Medicaid Services has instructed certified independent dispute resolution (IDR) entities to hold all payment determinations until further guidance is issued by the departments of Health & Human Services, Labor, and Treasury.
CMS, HHS Release Resources for No Surprises Act
The Centers for Medicare & Medicaid Services (CMS) and Department of Health and Human Services (HHS) recently released a variety of resources related to the No Surprises Act.
CMS Extends Enforcement Discretion on Certain Self-Pay Good Faith Estimate Requirements
The Centers for Medicare & Medicaid Services (CMS) has issued frequently asked questions (FAQs) regarding good faith estimate (GFE) requirements for uninsured or self-pay individuals.
CHA Encourages Members to Respond to CMS about No Surprises Act
CHA has issued draft comments in response to the Centers for Medicare & Medicaid Services’ (CMS) request for information (RFI) on the advanced explanation of benefits (AEOB) and good faith estimate (GFE) requirements of the No Surprises Act. The No Surprises Act addresses surprise medical billing at the federal level. CHA encourages members to use its […]
CMS Updates No Surprises Act Consumer Notices and Independent Resolution Process Guidance
The Centers for Medicare & Medicaid Services has released updated consumer notices and, separately, guidance related to the Independent Dispute Resolution Process. The model notice of patient protections that providers should use in 2023 is available here and begins on page 10. The standard notice and consent form that providers should use to document a […]
Tri-agencies Release New Independent Dispute Resolution Form
The Departments of Labor, Treasury, and Health and Humans Services (tri-agencies) released an updated web form that replaces prior methods for submitting offers to independent dispute resolution (IDR) entities.
CMS Seeks Input on Advanced Explanation of Benefits and Good Faith Estimate Requirements
The Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) on the advanced explanation of benefits and good faith estimate requirements of the No Surprises Act, which addresses surprise medical billing at the federal level.
CHA Issues Summary of No Surprises Act Final Rules
CHA has issued a members-only summary, prepared by Health Policy Alternatives, Inc., of the final rules on requirements related to surprise billing recently issued by the Departments of Treasury, Labor, and Health and Human Services.
New Resource Available on Applicability of Federal Independent Dispute Resolution Process
The Centers for Medicare & Medicaid Services has released a new resource to assist in determining whether the federal independent dispute resolution process or a specified state law or all-payer model agreement applies for determining out-of-network claims covered under the No Surprises Act.
Tri-agencies Release No Surprises Act Final Rule in Response to Legal Decision, Issue Additional Implementation Resources
The Departments of Labor, Treasury, and Health and Human Services (tri-agencies) have issued a long-anticipated No Surprises Act final rule.