News & Analysis as of

Out of Network Provider New Legislation

ArentFox Schiff

Three Administrative Law Takeaways from the Texas Medical Association Rule Challenge Decision

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New legislation often starts a cat-and-mouse game between the executive branch and regulated entities related to how statutory language is implemented. While we often write about environmental statutes, the procedural...more

Rivkin Radler LLP

Provider Requirements Under the No Surprises Act

Rivkin Radler LLP on

The federal No Surprises Act, effective January 1, 2022, established new requirements for healthcare providers, facilities, and providers of air ambulance services to protect consumers from “surprise” medical bills. These...more

Health Care Compliance Association (HCCA)

[Webinar] Out-of-Network and Balance Billing Restrictions - November 3rd, 12:00 pm - 1:30 pm CDT

Learning Objectives: - Obtain a high-level overview of the federal No Surprises Act - Identify state laws regarding balance billing and how they interact with the new federal law - Explain the effects on communication...more

Sheppard Mullin Richter & Hampton LLP

Federal Government Announces Enforcement Discretion, Deferral For Certain Price Disclosures And Future Rulemakings

Health plans and issuers racing to implement overlapping price transparency and disclosure requirements in response to the Transparency in Coverage final rule (TiC Final Rule) and the Consolidated Appropriations Act, 2021...more

Moritt Hock & Hamroff LLP

The No Surprises Act: Congress Takes Aim at Surprise Medical Bills

In the closing days of 2020, Congress passed federal legislation aimed at protecting patients against surprise medical bills and facilitating payment dispute resolutions among providers and insurers. Slated to take effect on...more

Greenbaum, Rowe, Smith & Davis LLP

Federal “No Surprises Act” Brings National Oversight Of Unexpected Billing For Healthcare Services

In the waning days of Donald Trump’s administration, the federal government passed the “No Surprises Act,” which becomes effective January 1, 2022. Like many recent state laws, the legislation is aimed at protecting patients...more

Hogan Lovells

No Surprises Act prohibits balance billing, creates arbitration process for out-of-network providers

Hogan Lovells on

Effective January 1, 2022, the “No Surprises Act” signed into U.S. law as part of H.R. 133, “Consolidated Appropriations Act, 2021,” implicates (1) emergency services provided by non-participating providers at participating...more

Dentons

No Surprises Act Limits Out-of-Network Charges

Dentons on

As part of the COVID-19 relief legislation passed at the end of 2020, Congress adopted the “No Surprises Act” which prohibits out-of-network providers from balance billing patients for charges above the rates paid by their...more

Groom Law Group, Chartered

[Webinar] Surprise Billing Law Imposes New Requirements for Plans and Issuers - January 13th, 2:00 pm - 3:30 pm ET

This webinar will include a discussion on the various provisions of the new surprise billing law, how it interacts with current law, expected guidance from the Biden Administration, and implications for health insurance...more

Sheppard Mullin Richter & Hampton LLP

No Surprises Act Comes as a Surprise – Consolidated Appropriations Act Includes New Restrictions on Surprise Bills

On December 28, 2020, the Consolidated Appropriations Act, 2021 (“Appropriations Act”) was passed into law. The Appropriations Act included the No Surprises Act (“Act”), which seeks to protect patients from surprise medical...more

Husch Blackwell LLP

Texas Department Of Insurance Rolls Out Final Rules On Out-Of-Network Notices And Disclosures

Husch Blackwell LLP on

On June 19, 2020, the Texas Department of Insurance adopted final rules specifying patient notice and election requirements in order for out-of-network providers to balance bill. The final rules replace similar emergency...more

Sheppard Mullin Richter & Hampton LLP

An Update: Despite Resistance, Surprise Billing Restrictions See Continued Legislative Activity

As discussed in our December 13, 2019 blog post on Surprise Billing, states have taken the lead on protecting patients against surprise bills, as the numerous pending bills before the House on the issue have stalled. Now in...more

Baker Donelson

Congress's Surprise Billing Showdown

Baker Donelson on

This year, Congress remains focused on passing legislation to tackle the issue of surprise billing where patients face unexpected and often exorbitantly high bills from out-of-network hospitals or physicians. ...more

Seyfarth Shaw LLP

New Surprise Billing Legislation and Rules Go Into Effect on January 1

Seyfarth Shaw LLP on

New legislation passed in the 2019 session of the Texas Legislature, SB 1264, went into effect on January 1, 2020. The statute protects Texas residents from so-called surprise billing, where patients receive costly medical...more

Brownstein Hyatt Farber Schreck

New Colorado Surprise Medical Billing Law Arbitration Provisions, Explained

So-called surprise medical bills were among the hottest topics in the news nationwide in 2019 and generate significant political activity. The term describes the situation in which a patient who has health insurance receives...more

Holland & Hart - Health Law Blog

Federal and New Mexico Surprise Billing Protections

Surprise billing protections are part of both state and national policy agendas this year in an effort to provide health-care transparency and consumer transparency. New Mexico’s new law now protects consumers by specifically...more

Mintz - Health Care Viewpoints

New York Seeks to Add Greater Protections Against Surprise Bills

Last week, the New York State Department of Financial Services released a proposed amendment to the regulations promulgated under the state’s Emergency Medical Services and Surprise Bills law (the SBL), which adds additional...more

Polsinelli

Texas Passes Consumer Protection Law On Surprise Medical Bills

Polsinelli on

Governor Abbot recently signed Senate Bill 1264 which, effective September 1, 2019, provides consumer protections against certain medical and health care billing by certain out-of-network (“OON”) providers. Originally...more

Robinson+Cole Health Law Diagnosis

Connecticut Enacts Budget that Includes Provisions Affecting Health Care Providers

Connecticut Governor Ned Lamont recently signed into law Public Act No. 19-117 (PA 19-117), which contains provisions affecting health care providers, including revisions to the hospital provider tax, a prohibition on...more

Mintz - Health Care Viewpoints

New Jersey Regulates Out-Of-Network Billing

News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for out-of-network services in New Jersey. Known as the “Out-of-Network Consumer...more

Nossaman LLP

Is Your Surgery Center Ready for California’s Surprise Medical Billing Law?

Nossaman LLP on

A new California law (AB 72) limits the amount that out-of-network surgeons and other health care professionals may bill patients for covered non-emergency services provided at a contracted facility, such as an ambulatory...more

Buchalter

Are You Ready for AB 72?

Buchalter on

To protect patients from receiving an unexpected surprise bill when they seek care at in-network facilities from out-of-network providers, Governor Brown signed AB 72: California’s surprise out-of-network law. The new law...more

Sheppard Mullin Richter & Hampton LLP

When your Hospital-of-Choice is In-Network but, SURPRISE, your Anesthesiologist is Not: California’s AB-72 and Other State...

Regardless of a patient’s diligence in selecting an in-network hospital, ambulatory surgery center, or other health facility for treatment, patients are still being saddled with surprisingly high medical bills that include...more

Snell & Wilmer

Arizona Enacts “Surprise Out-Of-Network” Balance Billing Law

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Arizona has joined the national trend of trying to solve the “problem” of “surprise medical out-of-network bills.” The prevalence of this concern was reported in the New England Journal of Medicine which stated that 22% of...more

Buchalter

California Clamps Down On Surprise Out-Of-Network Bills

Buchalter on

On September 23, 2016, Governor Brown signed AB 72, California’s surprise out-of-network law. The bill protects patients who seek care at an in-network facility from balance billing by individual health care providers who are...more

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