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
On August 2,2024, the Fifth Circuit affirmed the vacatur of federal rulemaking related to the No Surprises Act’s (NSA) Independent Dispute Resolution (IDR) process. The Court held that the No Surprises Act does not permit the...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
Although most of the recent focus around the implementation of the Inflation Reduction Act (“IRA”) by the press and industry stakeholders has been on the Medicare Drug Price Negotiation Program, the IRA has several other...more
In the 118th Congress, the US House of Representatives is keenly interested in healthcare price transparency. Three House committees—Energy and Commerce, Ways and Means, and Education and the Workforce—each approved...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 October 2020, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Transparency in Coverage Rule (“the Rule”), requiring most health insurance plans and issuers offering individual or group coverage to...more
Providers should be aware consumers now have access to CMS resources that help them understand their rights under the No Surprises Act (NSA). In general, the NSA protects healthcare consumers from receiving surprise medical...more
The May Monthly Minute examines a recent Seventh Circuit decision upholding unambiguous plan language against class action attack, the status of the federal IDR process under the No Surprises Act, and the DOL’s recent...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
This year, Foley’s Health Benefits Practice has released multiple alerts on several of the new group health plan requirements set forth by the Consolidated Appropriations Act of 2021 (CAA) and the Transparency in Coverage...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
The No Surprises Act (“NSA”) is a federal law that went into effect January 1, 2022. The NSA statute was enacted as part of the Consolidated Appropriations Act, 2021 and has been implemented by three interim rules jointly...more
The No Surprises Act (NSA) went into effect Jan. 1, 2022, but since the effective date, there have been numerous updates and changes regarding the NSA and compliance with it. We examine the key NSA 2022 changes and details of...more
On August 19, 2022, the United States Department of Health and Human Services, Department of Labor, and Department of the Treasury (the Departments) published a new final rule (Final Rule) under the federal No Surprises Act,...more
The “law of unintended consequences” describes the general sociological principle that for every action there is an unintended or unanticipated outcome. An influential examination of the concept was published in 1936 by...more
The No Surprises Act (“NSA”) went into effect on January 1, 2022. The NSA places numerous obligations on certain healthcare providers, facilities, and providers of air ambulance services to protect consumers against surprise...more
The Centers for Medicare & Medicaid Services’ Transparency in Coverage Final Rule took effect on July 1, following a six-month delay in implementation to allow payers to come into compliance....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
Executive Summary - The California Department of Managed Health Care (“DMHC”) issued a recent guidance interpreting the application of the No Surprises Act (“NSA”)—a new federal law prohibiting out-of-network healthcare...more
Last week, the California Department of Managed Health Care (DMHC) issued an All-Plan Letter (APL) stating that California case law and the Knox-Keene Health Care Service Plan Act of 1975 (the Knox-Keene Act) constitute...more
What You Need to Know- •A federal court sided with challengers in finding that certain CMS rules conflict with the federal No Surprises Act, pressuring healthcare providers to lower their offers in arbitration. ...more
On February 23, the federal District Court in the Eastern District of Texas struck down key provisions of regulations issued by the federal Departments of Health and Human Services, Labor, and the Treasury (Departments) and...more
In this second installment of this blog series on the No Surprises Act interim regulations (NSA) we discuss: i) notice and consent requirements for out of network providers providing services at participating health care...more
The Eastern District of Texas recently issued its opinion in Texas Medical Association v. United States Department of Health and Human Services, et al., invalidating key portions of regulations implementing the out-of-network...more