Surprise Billing

Providers Accuse NC Payer of Abusing No Surprises Act, Cutting Rates

by Sarai Rodriguez

The American Society of Anesthesiologists (ASA) recently accused BlueCross BlueShield of North Carolina of abusing the No Surprises Act to manipulate the market by pressuring clinicians into lower...

CMS Provides Guidance on Good Faith Estimates for No Surprises Act

by Jacqueline LaPointe

CMS has released 11 documents to help providers comply with the No Surprises Act’s requirement that providers give patients a “good faith estimate” of expected charges. The No...

HHS Report: State Surprise Billing Laws Offer Limited Protection

by Jacqueline LaPointe

A new report from researchers in HHS' Office of the Assistant Secretary for Planning and Evaluation (ASPE) shows that most states have enacted laws to protect consumers from surprise billing,...

HHS to Form Ambulance Billing Advisory Committee, Per No Surprises Act

by Jacqueline LaPointe

HHS is creating a federal advisory committee to address ground ambulance billing practices in its latest step toward No Surprises Act implementation. In an announcement on Friday, HHS said the Ground...

Private Equity-Backed Air Ambulances Major Culprit of Surprise Bills

by Sarai Rodriguez

Prior to The No Surprise Act, many air ambulance rides left patients at risk for receiving a surprise bill, according to a USC- Brookings Schaeffer Study.   The air ambulance market has...

Lawmakers Seek Changes to No Surprises Act Implementation

by Sarai Rodriguez

A bipartisan group of 152 House members wrote to the secretaries of Health and Human Services, Treasury and Labor and urged them to amend the interim final rule (IFR) that will implement the No...

Texas Medical Association Sue Feds Over IDR for Surprise Billing

by Jacqueline LaPointe

The Texas Medical Association is taking action against a regulation slated to implement the No Surprises Act, a federal surprise billing law taking effect on January 1st. The Association recently...

Air Ambulance Prices Rose Substantially for Commercially Insured

by Jacqueline LaPointe

The price for air ambulance transports has risen substantially over the past couple of years, especially for commercially insured patients, according to a recent FAIR Health analysis. The analysis...

Surprise Billing Regulation a Gift to Payers, Blow to Providers

by Jacqueline LaPointe

The American Medical Association (AMA) is calling the latest in a series of surprise billing regulations “an undeserved gift to the insurance industry that will reduce [healthcare] options for...

Independent Dispute Resolution Detailed in New Surprise Billing Rule

by Jacqueline LaPointe

The Biden-Harris Administration has released a long-awaited interim final rule that will explains how payers and providers will agree on an out-of-network rate when surprise billing occurs. The rule...

HHS Proposes More Surprise Billing Compliance Rules

by Jacqueline LaPointe

HHS and other federal departments have released a notice of proposed rulemaking (NPRM) that would impose civil monetary penalties of up to $10,000 on providers and facilities with surprise billing...

What the No Surprises Act Means for Providers

by Emily Sokol, MPH

In December 2020, Congress passed the No Surprises Act to reduce unexpected medical bills on patients. But implementing the regulations by the January 2022 deadline might be a challenge for...

AHA Addresses No Surprises Act Patient Notice and Consent Provisions

by Jill McKeon

AHA released comments regarding CMS’ guidance on notice and consent and public disclosure provisions under the No Surprises Act, recommending that CMS make some changes to the documents to reduce...

What Revenue Cycle Can Do to Prepare for Surprise Billing Compliance

by Jacqueline LaPointe

A prohibition on surprise billing is coming at the start of next year and federal agencies have started to release what surprise billing compliance will look like. These new compliance requirements...

1 in 5 Childbirths Lead to Surprise Billing, Study Shows

by Jill McKeon

One in five privately insured families who had in-network deliveries in 2019 received surprise bills for childbirth or newborn hospitalizations, according to a study published in JAMA Health Forum....

Biden Administration Releases Surprise Billing Regulations

by Jacqueline LaPointe

Several US departments, including HHS, have released much-anticipated surprise billing regulations to implement the No Surprises Act, a law passed last year that aims to protect patients from...

Hospitals Offer Suggestions for Surprise Billing Law Implementation

by Jacqueline LaPointe

With new details on implementation of the No Surprises Act slated to come in early July, the Federation of American Hospitals (FAH) has offered several suggestions for combatting surprise billing to...

Physicians Collect More From Surprise Medical Bills in ED

by Jacqueline LaPointe

Physicians in a hospital’s emergency department (ED) collected significantly more of the charged amount for likely surprise medical bills compared to other patient cases, a new study in Health...

Key Ways Providers Can Prepare for New Surprise Billing Rules

by Jacqueline LaPointe

Starting January 1, 2022, healthcare providers will be subject to a new surprise billing law that makes it illegal for providers to bill patients more than in-network cost-sharing for out-of-network...

Surprise Billing Arbitration Favors Providers, But Rates Are High

by Jacqueline LaPointe

An out-of-network surprise billing solution in New Jersey favors providers, paying them significantly more than in-network prices for the set of services in dispute, according to a new Health Affairs...