News To Share
Texas judge rules in favor of doctors in latest suit over surprise billing process.
The decision is expected to increase the number of provider claims, especially for smaller amounts.
This week, the Departments of Health and Human Services (HHS), Labor, and the Treasury released two reports on the No Surprises Act federal Independent Dispute Resolution (IDR) process and federal IDR portal.
These reports highlighted the Departments’ plans to consider additional rulemaking to improve the process for determining the eligibility of surprise medical billing disputes and increase the speed by which payment determinations are made.
Surprise Billing Law: What’s Working and Not Working?
Check out the latest episode of the AAOS Bone Beat Advocacy podcast featuring Alla LaRoque, President of HaloMD, as she discusses the key healthcare policy and challenges of the No Surprises Act and IDR with Adam J. Bruggeman, MD, MHA, FAAOS, FAOA.
Payment disputes between providers and health plans
This latest report suggests patients are being effectively protected from surprise medical bills covered by the No Surprises Act.
It shows that insurers and providers are working together to eliminate balance bills and address any issues that arise…
Federal Independent Dispute Resolution (IDR) Process
Guidance for Disputing Parties
Initial Report on Independent Dispute Resolution (IDR) Process
Texas Medical Association Wins No Surprises Act Rule Court Case
A district court has ruled in favor of the Texas Medical Association, which has challenged HHS’ No Surprises Act rule describing the independent dispute resolution process.
Read More Here
Texas Medical Association Files Fourth Lawsuit Against No Surprises Act Over Arbitration Fees Hike
Chart Regarding Applicability of the Federal Independent Dispute Resolution Process in Bifurcated States
No Surprises Act Prevents More than 9 Million Surprise Bills Since January 2022
The No Surprises Act’s Continuity of Care, Provider Directory, and Public Disclosure Requirements
The No Surprises Act* introduced new requirements for providers, facilities, and providers of air ambulance services to protect individuals from surprise medical bills.
Test Your Knowledge On The No Surprises Act
Take our interactive quiz.
No Surprises Act Enforcement
The No Surprises Act, signed into law in 2020, went into effect for individual and group health insurance plans on January 1, 2022. The new law addresses surprise bills for medical care in any of the following three circumstances…
With the evidence piling up, health economists have classified 2022 as the worst financial year for hospitals in decades.
At the same time, payers are seeing record breaking profits. This Becker’s article breaks down the widening of the gap between payers and healthcare providers.
Medical bills heading to dispute resolution far more often than anticipated.
This article breaks down U.S. providers who initiated the most out-of-network disputes in 2022.
CMS recently released an amendment for the Federal Independent Dispute Resolution (IDR) Process under the No Surprises Act,
increasing the administrative fee from $50 to $350 per party for disputes initiated during calendar year 2023. Click to learn more.