Price Transparency Enforcement Is Still A Shared Responsibility
Despite all the noise around the updates, there’s one area that’s been conspicuously absent this year: enforcement of patient estimate requirements.
Beyond Broken Links: The High Stakes of Provider Directory Accuracy in the No Surprises Era
Inaccuracies don’t just erode trust — they lead directly to surprise billing events, missed appointments, care delays, and in some cases, enforcement action.
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Could QuantalX’s Device Make Managing Brain Health Easier?
CEO and neuroscientist Dr. Iftach Dolev on how the new device can bring a powerful tool to psychiatrists and neurologists alike.
CMS Lowers No Surprises Act Fee After Court Nixes Price Hike
CMS recently announced that it will change the administrative fee that providers and insurers must pay when initiating a reimbursement dispute under the No Surprises Act — the agency is lowering the fee from $350 to $50. This move came a week after the Texas Medical Association won a court case challenging HHS over its 600% price hike on the fee.
3 Recent Healthcare Wins for Employers
Amid the difficult healthcare environment, it's important to note that there have been some wins for employers, said Katy Spangler, senior advisor of the American Benefits Council, during the Midwest Business Group on Health conference held Tuesday. These wins include the No Surprises Act and price transparency rules.
What Keeps One Advocate up at Night About the No Surprises Act
Patricia Kelmar, healthcare campaigns director at the Public Interest Research Group, is an advocate for the No Surprises Act. But there's one thing that bothers her: the fact that providers can ask patients to waive their surprise billing protections, she said Tuesday when speaking at the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum in Washington, D.C.
Initially Aggressive on Deadlines, NSA Rollout Becomes Measured
If the NSA-implementing agencies could plot out and publish their plan for adopting standards, publishing regulations, and setting new compliance dates for the NSA AEOB and provider directory requirements, it would help tremendously to level set on expectations and help organizations budget and plan for actual implementation.
The Power of One: Redefining Healthcare with an AI-Driven Unified Platform
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
The Future of Digital Health and Healthcare IT in a Post-Covid World
Implementing and pursuing innovation in digital health and healthcare IT should be a priority for all U.S. healthcare providers and payers — especially as the lessons and response to the Covid-19 pandemic become permanently part of our everyday lives.
Building on the groundwork laid by the No Surprises Act
Although the “Requirements Related to Surprise Billing: Final Rule,” was released on August 19th, the No Surprises Act roll-out is far from complete. Its complexity means adherence, oversight, and enforcement, as well as system and process changes, are still works in progress.
1 in 5 Americans received surprise bills despite law, many lack health insurance literacy, reports find
Skyrocketing medical bills and a lack of understanding in the healthcare system is putting financial stress on Americans in 2022, several recent reports have found. Despite the No Surprises Act, which protects consumers from surprise billing, many Americans said they’re still receiving unexpected bills, and a low healthcare literacy is making it difficult for them to know how to handle high medical bills, the surveys find.
How to meet the demands of the No Surprises Act
Patients deserve high-quality care and better outcomes, as well as equitable, consistent and transparent billing experiences. So how do we get there?
As Healthcare and Biopharma Companies Embrace AI, Insurance Underwriters See Risks and Opportunities
In an interview, Munich Re Specialty Senior Vice President Jim Craig talked about the risk that accompanies innovation and the important role that insurers play.
No Surprises Act: the Trojan horse of healthcare legislation
This legislation has the potential to drastically reshape the economics of healthcare in America, but it remains unfamiliar to those it affects most—namely, patients, doctors and outpatient surgery centers.
Mental health therapists seek exemption from part of law to ban surprise billing
Therapists say their professional codes of ethics already require disclosure to patients of per-visit costs. Requiring diagnostic billing codes in the estimate before even seeing a patient — as they interpret the rule — is unethical, they argue, and tallying up what might be weeks or even months of treatment costs could keep some patients from undergoing care.
What does the federal ‘No Surprises Act’ mean in California?
Betty Chow, a Los Angeles resident, had a cervical disc replaced in August 2020 at a surgery center that was part of her Anthem Blue Cross PPO network. Thirteen months later, she was blindsided by a bill for nearly $2,000 from the anesthesiologist who was on her surgical team but was not contracted with her […]
Texas Medical Association continuing opposition to No Surprises Act ruling for determining out-of-network pricing
The Texas Medical Association (TMA) filed a brief on Monday to further oppose the ruling on the No Suprises Act that currently allows aribtrators to use the average in-network rate to determine out-of-network cost.
Physicians group files brief supporting AMA/AHA Lawsuit
Physicians Advocacy Institute, American Association of Neurological Surgeons, and Congress of Neurological Surgeons lead a coalition of physicians groups in filing an amicus curiae brief backing the American Medical Association and American Hospital Association’s lawsuit opposing the dispute regulation guidelines of the No Surprises Act that went into effect January 1.