About Surprise Billing
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills for most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. While California hospitals are already leaders in ensuring patients understand their out-of-pocket costs and offering clear, written discount and charity care policies to help certain patients, new AHA guidelines are a way for hospitals to reinforce their commitment.
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 patient’s desire to receive care out of network and be billed accordingly in 2023 is available here and begins on page 9.
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.
CMS Posts New No Surprises Act Implementation FAQs
The Centers for Medicare & Medicaid Services has issued new No Surprises Act frequently asked questions (FAQs).
Federal Departments Issue Independent Dispute Resolution Process Checklist
The Departments of Treasury, Labor, and Health and Human Services have issued a checklist of independent dispute resolution (IDR) process requirements for group health plans and group and individual health insurance issuers to help ensure compliance with the No Surprises Act (NSA) and its implementing regulations.
CMS Opens Federal Independent Dispute Resolution Process
On April 15, the Centers for Medicare & Medicaid Services (CMS) opened the federal independent dispute resolution (IDR) process for providers to resolve out-of-network payment issues covered under the No Surprises Act (NSA).