The Future of Good Faith Estimates Under the No Surprises Act
R1 Regulatory TeamJanuary 18, 2023
The No Surprises Act of the 2021 Consolidated Appropriations Act (“NSA”) established requirements for healthcare providers to deliver Good Faith Estimates (“GFEs”) for scheduled services or upon patient request.
Key Takeaways:
- Indefinite extension of co-provider and co-facility enforcement ...
Hospital Price Transparency: Lessons Learned, Best Practices
R1 Regulatory TeamDecember 19, 2022
Federal price transparency requirements for hospitals from the Centers for Medicare & Medicaid Services (CMS) provide patients with an unprecedented amount of insight into the costs for medical services.1
In theory, more pricing information should ...
Revenue cycles challenged by mandates of No Surprises Act
Susan MorseDecember 5, 2022
The No Surprises Act has reportedly done its job in preventing an estimated nine million surprise medical bills since going into effect at the start of this year, ...
HFM: No Surprises Act Regulations Remain Moving Target for Compliance
Nick HutNovember 3, 2022
Amid all the rules stemming from the No Surprises Act, a looming mandate for providers to send cost estimates to health plans looks like the biggest stress inducer.
Various regulations under the No Surprises Act have created strain for healthcare finance professionals since the initial rules were published in mid-2021, ...
Early Insights on Independent Dispute Resolution Under No Surprises Act
R1 Regulatory Affairs & Regulatory Compliance TeamSeptember 23, 2022
On August 19, 2022, the Departments of Health and Human Services (“HHS”), Labor, and the Treasury (“the Departments”) issued a Federal Independent Dispute Resolution Process Status Update.1 In the statement, the Departments reported that between April 15th and August 11th, 2022, providers initiated ...
No Surprises Act 2022: What Physicians Still Need to Know
Kathryn BeardJuly 7, 2022
On January 1, 2022, the federal No Surprises Act (NSA) went into effect. At its heart, the NSA aims to empower patients to make more informed financial decisions about their care while eliminating unexpected bills which, prior to NSA protections, have sometimes led to financially ...
Court Vacates No Surprises Act Regulations Favoring Payors in Reimbursement Disputes
Kathryn BeardFebruary 25, 2022
On February 23, 2022, a Texas district court found that portions of the No Surprises Act ...
Outrageous Hospital Charges – Don’t Blame the Hospital
Dr. Ronald HirschFebruary 3, 2022
There has been a lot of media attention to hospital charges recently. With the COVID-19 pandemic, The Centers for Medicare & Medicaid Services (CMS) worked miracles to allow health systems to be paid a facility fee for many remote visits to cover the overhead costs of such visits. The price transparency regulations require more ...
HFMA: New Surprise Billing Regulations - Assessing Patient Network Status
Nick HutJanuary 10, 2022
- With new surprise billing regulations in place, providers should ensure they have efficient processes for gauging whether a patient is in-network.
- For some providers, the task may prove to be more trouble than it’s worth in terms of opportunities to balance-bill patients.
- The new regulations make communication ...
HFMA: Surprise Billing Regulations and How Providers Should Prepare
Nick HutDecember 20, 2021
- Providers have had a mere three months to implement the processes needed to comply with a new requirement to furnish uninsured patients with good-faith price estimates ahead of services.
- A key early step for any provider is to determine whether it generally will be the entity responsible for providing estimates, i.e., the ...
