On December 2, 2022, Health & Human Services issued guidance (HHS) delaying the requirement that convening providers include co-provider charges in their good faith estimates for self-pay patients. Previously, the requirement for a scheduling provider to include the charges of other providers in their good faith estimate to self-pay patients if those providers were also providing services to the patient in connection with the scheduled service was to be enforced commencing January 1, 2023. However, HHS is now delaying enforcement of this requirement pending new rule-making on implementation standards. According to the guidance, HHS intends to establish standards for an application programming interface (“API”) for providers and facilities to adopt to automate the creation of good faith estimates when multiple providers are involved in the scheduled service. The future compliance date will be announced after the new standard has been published. The new guidance delays only the requirement for a convening provider to include co-provider charges in its good faith estimate for self-pay patients. Providers must still provide self-pay patients with a good faith estimate regarding their expected charges within the required time frames and upon request.

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No Surprises Act: Frequently Asked Questions - Volume 2