News & Analysis as of

Out of Network Provider Patients

Foley & Lardner LLP

Massachusetts “Patients First Act” Implementation and Enforcement Re-Extended

Foley & Lardner LLP on

The Massachusetts Senate proposed an amendment on Monday December 2, 2024, that would delay implementation and enforcement of the 2021 Patients First Act addressing health care cost transparency. Section 31 of the amendment...more

Blank Rome LLP

Colorado Supreme Court Rejects Hospital’s Claim for Balance Billing Out-of-Network Patient for Elective Services

Blank Rome LLP on

The Colorado Supreme Court’s decision in French v. Centura Health Corp. is a reminder of the importance of making sure that patient financial responsibility forms are clear and understandable to an average layperson...more

Sheppard Mullin Richter & Hampton LLP

DMHC Guidance Confirms that California Law, Not the Federal No Surprises Act, Governs Payment and Dispute Resolution Processes for...

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

Sheppard Mullin Richter & Hampton LLP

Q&A: The No Surprises Act’s Protections for Uninsured (or Self-Pay) Individuals

In our November 9, 2021, blog post on the No Surprises Act (“NSA”), we discussed new consumer protections against surprise out-of-network bills. In addition to protecting insured consumers from balance billing, the NSA...more

Bass, Berry & Sims PLC

First Installment of Surprise Billing Regulations Released

On July 1, the Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury (Departments) jointly issued interim final rules (IFR) implementing certain aspects of the No Surprises Act...more

Bradley Arant Boult Cummings LLP

Federal Agencies Release Interim Final Rule to Implement the No Surprises Act

Today, the Departments of Health and Human Services (HHS), Labor, and Treasury (the Departments) published an interim final rule (the Interim Final Rule) implementing certain provisions of the No Surprises Act,[1] which aims...more

K&L Gates LLP

The Federal No Surprises Act and Its Arbitration Provisions

K&L Gates LLP on

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

Troutman Pepper Locke

New Jersey Lawmakers Propose Bill Complicating Out-of-State Medical Care

Troutman Pepper Locke on

A group of New Jersey lawmakers recently introduced the Patient Protection Act (A5369, S3816), which would make it more difficult for doctors to transfer or refer patients to out-of-state providers or facilities....more

BakerHostetler

Waivers of Co-Pays and Deductibles: Insurance Benefit Exclusions Grow

BakerHostetler on

Recent changes to policy and plan language and increased litigation by third-party payers suggests that out-of-network providers who waive co-pays and deductibles may be in for some rough sailing. Providers must be aware of...more

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