The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law
Two District Courts have reached opposite conclusions on the enforceability of arbitration awards under the No Surprises Act (“NSA”). The two decisions, while far from the final word on the subject, highlight the most recent...more
Executive Summary - This project was designed to collect a broad range of perspectives from stakeholders and the literature to (1) understand the current state of the implementation of the Independent Dispute Resolution...more
As reported earlier in the MedLaw Blog (August 9, 2023), a federal District Court vacated portions of the No Surprises Act federal regulations. Thereafter, CMS halted the arbitration process for resolving disputes regarding...more
5 Questions is a periodic feature produced by Cornerstone Research, which asks our professionals, senior advisors, or affiliated experts to answer five questions. We interview Professor Erin Trish, of the Schaeffer Center...more
CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows...more
In the year following the implementation of the arbitration process established under the federal No Surprises Act (NSA), more than 330,000 disputes have been submitted for resolution. This figure far outpaces the predictions...more
The saga between health care providers and the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, “Departments”) continues apace, as a federal district court...more
The Texas Medical Association is yet again challenging the federal government’s implementation of the independent dispute resolution process established by the No Surprises Act, this time arguing the $350 fee to initiate the...more
The No Surprises Act (NSA), which went into effect January 1, 2022, was designed to protect patients from surprise medical bills when they are treated in out-of-network emergency departments or by out-of-network providers at...more
Controversy continues to surround the independent dispute resolution (IDR) provisions of the No Surprises Act (NSA). On November 18, bipartisan leadership of the House Ways and Means Committee sent a letter to the Secretaries...more
An appeal brought before the Texas Supreme Court could unleash a wave of legal action by out-of-network ER physicians pursuing insurers for underpayment of claims. Unlike in-network providers who negotiate reimbursement...more
On July 26, 2022, LifeNet was granted summary judgment in its challenge to portions of the second set of implementing regulations for the Independent Dispute Resolution (IDR) process for air ambulance providers under the No...more
The newly enacted federal No Surprises Act (NSA), intended to protect consumers from surprise balance billing, continues to be the subject of considerable controversy. On February 23, 2022, a U.S. District Court in Texas...more
On April 12, 2022, CMS issued new guidance for the independent dispute resolution (“IDR”) process under the No Surprise Billing Rules (“Rules”) in response to a U.S. District Court for the Eastern District of Texas judge...more
On February 23, 2022, the U.S. District Court for the Eastern District of Texas gutted portions of the interim final rule affecting the independent dispute resolution (“IDR”) process of the No Surprises Act (the “Act”). Tex....more
In this episode, Steven Pine and Gary Qualls discuss the arbitration provision under the federal No Surprises Act, controversy around the qualifying payment amount (QPA), a recent decision in a Texas federal court that...more
On February 23, 2022, Judge Jeremy Kernodle of the Eastern District of Texas ruled that certain parts of the Interim Final Rule Part II (the Rule) implementing the No Surprises Act (the Act) are invalid. Specifically, the...more
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
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
On 28 December 2020, the federal No Surprises Act (Act) was enacted. The Act seeks to protect patients from so-called “surprise medical bills” in certain emergency and nonemergency settings for out-of-network patients. This...more
The recently enacted Consolidated Appropriations Act, 2021 (the “Act”) not only funds the government and provides further relief in regard to the impact of the COVID-19 pandemic, but it also adopted a number of new...more
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
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