Health Care Dive

MARCH 17, 2023

In a new study, researchers analyzed health plan provider directories for over 40% of U.S. physicians, and found inconsistencies for 81% of doctors across five major insurers.

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Doctors 326

Health Care Dive

MARCH 21, 2023

The agency had previously paused and resumed earlier disputes between payers and providers after a Texas judge ruled against the federal government and vacated portions of the law that bans surprise billing.

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Health Care Dive

SEPTEMBER 22, 2023

On Thursday, the HHS and other departments proposed a rule that would raise the independent dispute resolution process fees from $50 to $150. Last month, a federal court vacated a rate of $350.

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Fierce Healthcare

MARCH 22, 2023

Senator slams HHS' implementation of No Surprises Act as 'big mess' after legal battles rking Wed, 03/22/2023 - 11:41

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Healthcare It News

AUGUST 8, 2022

Enterprise Taxonomy: Short Headline: 6 actions payers can take to prepare for the No Surprises Act Region Tag: Global Edition Node settings: Exclude from Accelerate RSS feed

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Health Care Dive

AUGUST 28, 2023

The ruling, which targets guidance related to the independent dispute resolution process, prompted the CMS to again pause all federal disputes.

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Regulations 246

HIT Consultant

NOVEMBER 28, 2022

The No Surprises Act (NSA) was meant to relieve the financial burden from consumers and help prevent unexpected, and sometimes massive, healthcare bills – a goal that providers, payors and the industry at large can get behind. But a recent survey from Morning Consult found that one in five patients will still receive a surprise bill.

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HIT Consultant

JUNE 12, 2022

As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a topic discussed by consumers and policymakers. Surprise billing can occur when a patient unknowingly receives care from providers that are outside their network. Surprise Billing Causes. Two-thirds of U.S.

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Regulations Medicare Patient Experience Medicaid 98

Fierce Healthcare

SEPTEMBER 3, 2021

Industry Voices—The No Surprises Act: Preparing payers for compliance and success. Fri, 09/03/2021 - 11:22.

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Clearwave Inc

MARCH 1, 2022

Reading Time: 3 minutes A summary of the 2021 No Surprises Act: The No Surprises Act (NSA) went into effect on January 1, 2022, protecting patients from surprise medical bills after treatment and requiring Good Faith Estimates (GFEs) for uninsured and self-paying patients. What’s a Surprise Medical Bill?

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Healthcare 52

Sheppard Health Law

SEPTEMBER 6, 2023

The status of the independent dispute resolution (IDR) process under the No Surprises Act (NSA) is ever-evolving. Providers are waiting on the sidelines as cases weave their way through the court system.

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Healthcare 52

Sheppard Health Law

JANUARY 19, 2024

You can find more information regarding the Act on the Sheppard Mullin Healthcare Blog. It will be reopened from the date the reopening of the comment period is published in the Federal Register (which is expected to be on January 22, 2024) to 14 days after that date.

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Healthcare 52

Sheppard Health Law

AUGUST 31, 2023

The QPA, Generally The Act sets forth the rates at which out-of-network emergency services and out-of-network non-emergency services furnished at in-network facilities must be reimbursed. These provisions of the July 2021 IFR and related guidance were similarly vacated.

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Regulations Medicaid Medicare Healthcare 52

Advanced Data Systems

JULY 30, 2021

John Doe is an inpatient at a hospital. He and his family might have a handle on services and treatments that were actually seen performed, or at least known about such as surgeries.

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Hospitals Healthcare 98

Sheppard Health Law

AUGUST 10, 2023

September 2021 Final Rule Provisions Regarding Batching The Act permits the “batching” of multiple qualified IDR items or services to be considered jointly, if they meet certain criteria, including that the items or services are related to the treatment of a similar condition.

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HIT Consultant

JUNE 16, 2022

The importance of the No Surprises Act (NSA) cannot be overstated, as surprise medical bills have long been burdensome for patients in the U.S. The purpose of the No Surprises Act is to prevent surprise out-of-network bills, often for emergency services. Since the act went into effect on Jan.

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Regulations Hospitals Medicaid Medicare 52

Health Policy News

OCTOBER 29, 2021

Implementation of the No Surprises Act (NSA) continued this fall with the release of a second interim final rule (IFR) on September 30, 2021. The NSA—which was signed into law.

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Medicaid Medicare 52

Sheppard Health Law

SEPTEMBER 22, 2022

On September 20, 2022, the American Hospital Association and American Medical Association announced they are still concerned the newly promulgated Final Rule departs from the legislative intent of the No Surprises Act, and indicated they may challenge the Final Rule in court. District Court for the Eastern District of Texas.

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Medicaid Medicare Regulations Accountability 52

Instamed

APRIL 25, 2022

article.resource.blog-lead-text p, article.post.blog-lead-text p,block-editor.blog-lead-text p{ line-height: 40px; font-size: 24px; font-weight: 100; } The No Surprises Act is designed to.

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Icanotes

JANUARY 10, 2022

The No Surprises Act of 2021 is intended to protect consumers from unexpected medical bills. This is called "balance billing," and it leaves many patients with a "surprise bill." . Clinicians are wondering what they should do to abide by the No Surprise Act, and we have some resources that may be helpful to you.

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Regulations Healthcare Providers Integration Hospitals 52

Sheppard Health Law

FEBRUARY 10, 2023

On February 6, 2023, the United States District Court for the Eastern District of Texas ruled in favor of the Texas Medical Association [1] and vacated portions of the final rule adopted in August 2022 (the “August 2022 Final Rule”) that applied to the Independent Dispute Resolution (“IDR”) process created by the No Surprises Act (the “Act”). [2]

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Accountability Healthcare Healthcare Providers Hospitals 52

Sheppard Health Law

FEBRUARY 24, 2023

If you have questions about eligibility for the Federal IDR process, or about other No Surprises Act requirements, the health care team at Sheppard Mullin will be happy to assist you. District Court for the Eastern District of Texas’ opinion on February 6, 2023, in the matter of Texas Medical Association, et al.

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Medicaid Medicare 52

Sheppard Health Law

NOVEMBER 9, 2021

As of January 1, 2022, patients will no longer be at risk for one of the most detested practices in healthcare: surprise out-of-network bills. What is a surprise bill? The above scenario is just one example of surprise billing that the federal No Surprises Act (the “Act”) is intended to prevent, beginning January 1, 2022.

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Regulations Hospitals Medicare Doctors 52

Health Care Dive

SEPTEMBER 20, 2023

Bipartisan lawmakers joined together to voice concerns about the implementation of the No Surprises Act, which critics say has created barriers to care.

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Fierce Healthcare

SEPTEMBER 20, 2023

American Physician Partners, a Brentwood, Tennessee-based hospital staffing firm, announced Tuesday that it and its affiliates have filed for Chapter 11 bankruptcy protections “to complete the orde | The company said it has wound down over 150 contracts in July and attributed its financial difficulties to the pandemic and the No Surprises Act.

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Hospitals 315

Health Care Dive

SEPTEMBER 21, 2023

The company said the COVID-19 pandemic, rising labor costs and a “problematic” implementation of the No Surprises Act challenged its finances.

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Briggs Healthcare

JANUARY 24, 2022

The next CMS Special Open Door Forum will be a deep dive for providers on the balance billing provisions of the No Surprises Act. Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare. Date: Wednesday, January 26, 2022. Time: 1:00PM – 2:00PM Eastern Time (ET). Please dial-in at least 15 minutes before call start time.

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Healthcare 75

Health Care Dive

JUNE 9, 2022

The contested provision in the No Surprises Act requires certain providers to assemble a comprehensive cost estimate for patients, including costs from other providers that could step in to provide care.

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Hospitals 337

Health Care Dive

APRIL 19, 2022

As a last resort, the No Surprises Act allows payers and providers to resolve payment disputes using arbitration. The online site that initiates the process is now open.

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Health Care Dive

OCTOBER 31, 2023

Tenet was also the latest for-profit operator to call out the impact of rising physician fees from the implementation of the No Surprises Act.

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Healthcare 167

Sheppard Health Law

APRIL 13, 2022

The California Department of Managed Health Care (“DMHC”) issued a recent guidance interpreting the application of the No Surprises Act (“NSA”)—a new federal law prohibiting out-of-network healthcare providers from balance-billing patients for certain emergency and non-emergency services—in California. Executive Summary.

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Regulations Medicare Healthcare Healthcare Providers 52

Health Care Dive

NOVEMBER 22, 2022

House Ways and Means Committee leaders “are severely disappointed to find that the August 2022 final rule violates the No Surprises Act in the same ways as before,” they wrote in a letter to regulators last week.

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Regulations 246

Health Care Dive

NOVEMBER 1, 2021

The No Surprises Act is slated to take effect on Jan. The lawsuit primarily takes issue with the independent dispute resolution process the regulations governing the law put in place.

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Regulations 300

Health Care Dive

NOVEMBER 17, 2021

While payers and providers must start complying with the No Surprises Act by Jan. 1, the fight over rules implementing the ban is heating up as provider groups object to what they think is a favoring of insurers.

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HIT Consultant

APRIL 17, 2024

Enhanced accuracy and completeness of health plans’ provider directories, aiding compliance with the No Surprises Act. Instant access for health economy stakeholders to analyze any U.S. provider list independently or alongside existing datasets and workflows.

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Healthcare Analytics Healthcare 95

HIT Consultant

NOVEMBER 7, 2023

What You Should Know: Health Payment Systems (HPS) today announced it has selected Madaket Health to help manage its provider directory and roster requirements for No Surprises Act (NSA) compliance. As a consequence, a significant 81% of the information entries in the five largest payer directories have proven to be inaccurate.

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Hospitals 98

HKLaw

DECEMBER 12, 2021

Miranda A. (..)

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