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Out of Network Provider Hospitals

McDermott Will & Emery

A Look into House Efforts on Hospital and Health Plan Price Transparency

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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

Dentons

No Surprises Act: Frequently Asked Questions - Volume 2

Dentons on

In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect patients from surprise billing. Some sections of the NSA became effective January 1, 2022, while other sections are on hold until regulations are...more

Schwabe, Williamson & Wyatt PC

Surprise Medical Bills in the Crosshairs:‎ Supreme Court Decision Places Additional Obligations on Health Care ‎Providers

On May 16, 2022, the Colorado Supreme Court issued an opinion that serves as a cautionary tale for health care providers hoping to bill patients at chargemaster rates. The court’s decision in French v. Centura Health turned...more

Epstein Becker & Green

Challenged in Court: Dispute Resolution Rules in Second Federal No Surprises Act Interim Final Regulations

Epstein Becker & Green on

On September 30, 2021, the federal Departments of Treasury, Labor, and Health and Human Services issued “Requirements Related to Surprise Billing; Part II,” the second in a series of interim final regulations (the “Second NSA...more

Epstein Becker & Green

Hotly Contested Dispute Resolution Rules in Second Federal No Surprises Act Interim Final Regulations Are Being Challenged in...

Epstein Becker & Green on

On September 30, 2021, the federal Departments of Treasury, Labor, and Health and Human Services issued “Requirements Related to Surprise Billing; Part II,” the second in a series of interim final regulations (the “Second NSA...more

Fox Rothschild LLP

The No Surprises Act Is Here: What Does It Require?

Fox Rothschild LLP on

The federal No Surprises Act went into effect on January 1, 2022. The Act is aimed at reducing “surprise bills” to patients in the context of services provided at hospitals and ambulatory surgical centers, and includes...more

Epstein Becker & Green

Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law

Epstein Becker & Green on

Is your organization ready for the No Surprises Act (NSA)? The law goes into effect January 1, 2022, and contains a new federal ban on surprise billing as well as new disclosure requirements. The NSA applies to certain...more

Manatt, Phelps & Phillips, LLP

[Webinar] Navigating the No Surprises Act: Your Guide to Requirements, Challenges & Compliance - August 2nd, 1:00 pm - 2:00 pm ET

What New Obligations Does the No Surprises Act Impose on Health Systems and Health Plans—and How Can You Prepare for the Impact? Learn the Answer at a New Manatt Webinar. The No Surprises Act (NSA)—set to take effect...more

Husch Blackwell LLP

Federal Guidance On Balance Billing: The No Surprises Act And Its Interim Final Rule: Part I

Husch Blackwell LLP on

On July 1, 2021, the Office of Personnel Management (“OPM”), the Internal Revenue Service (“IRS”), the Department of Treasury (“Treasury”), the Employee Benefits Security Administration (“EBSA”), the Department of Labor...more

Payne & Fears

Consumer Class Action Against Sutter Health Allowed to Proceed

Payne & Fears on

A recent case in the Northern District of California presents a reminder that hospital systems need to consider antitrust issues when negotiating multi-hospital contracts with health plans. Unfortunately, even when hospitals...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

Proskauer Rose LLP

No Surprises: Congress Enacts Surprise Bill Law and Adds Mandatory Billing Transparency

Proskauer Rose LLP on

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

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

Surprise Billing Initiatives Face Not-So-Surprising Resistance

“Surprise billing,” also known as “balance billing,” is one of few areas that garners bipartisan support. Surprise billing occurs when a patient inadvertently goes out of his or her insurer’s network, resulting in a “surprise...more

Ballard Spahr LLP

Health Care and Price Transparency: The Latest Summary

Ballard Spahr LLP on

Federal executive agencies recently published two rules, one final and one proposed, aimed at publicizing the various costs associated with health care. A final rule, promulgated by the Department of Health and Human Services...more

Dorsey & Whitney LLP

Hospital Price Transparency Rule Finalized; Health Plan Transparency Rule Proposed

Dorsey & Whitney LLP on

The Centers for Medicare and Medicaid Services (CMS) has issued a final rule to require every hospital licensed in the United State to make public a robust set of standard charges for every item or service that the hospital...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

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

Alston & Bird

No Surprise, Congress Focuses on Surprise Billing

Alston & Bird on

Despite partisan rancor in Congress over health care, one thing both parties agree on is that patients should not be surprised by an out-of-network health care bill. Our Employee Benefits & Executive Compensation and Health...more

Patrick Malone & Associates P.C. | DC Injury...

Congress and White House find a bipartisan target in medical bills and prices

Doctors, hospitals, health insurers, and Big Pharma have become so abusive to patients with their billing and pricing that they may have accomplished what many consider a political impossibility ?  angering Democrats and...more

Holland & Knight LLP

Hospitals, Doctors (and Others) Beware: DOJ May Apply Travel Act to Healthcare Prosecutions - Arrangements Viewed Under the...

Holland & Knight LLP on

• A recent federal jury verdict in Dallas affirms the U.S. Department of Justice's determination to extend federal prosecutions to healthcare arrangements involving commercial payers by utilizing the federal Travel Act, which...more

Sheppard Mullin Richter & Hampton LLP

Balanced Billing in California: Update Regarding 2016’s A.B. 72 and an Overview of Newly Introduced Bill A.B. 1611

Balanced billing or “surprise billing” has been getting increased attention at both the federal and state level. Balance bills arise when a payor covers out-of-network care, but the provider bills the patient for amounts...more

Mintz - Health Care Viewpoints

Surprise Medical Bills Gain National Attention

No one wants to be faced with a large, unexpected medical bill after receiving health care services. Unfortunately, patients often find themselves in this situation after seeking emergency treatment or transportation,...more

Saul Ewing LLP

New Jersey Enacts Out-of-Network Statute Affecting Hospitals, Surgery Centers, Physicians and Insurers

Saul Ewing LLP on

On June 1, 2018, New Jersey Governor Phil Murphy signed into law the “Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act” (the “Act”). In the preamble to the Act, the New Jersey...more

Baker Donelson

CMS Issues Updated Medicare Payment and Billing Policies for 340B Hospitals

Baker Donelson on

On April 2, 2018, CMS issued updated guidance related to the dramatic Medicare payment reductions that went into effect this year for certain 340B hospitals. The guidance explains the planned application of the payment cuts...more

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