Category: Medical Billing

big-surprises-in-the-no-surprises-act

Big surprises in the No Surprises Act

  In one of the biggest attempts by the federal government to combat surprise medical billing, Congress in late 2020 passed the No Surprises Act (NSA), which imposes a host of new transparency and coverage requirements for employer-sponsored group health plans. Many of the most significant coverage changes were required to be implemented on Jan. […]
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Medical organizations continue to fight surprise-billing dispute process: 5 details

A coalition of medical organizations, including the Physicians Advocacy Institute and 16 state medical associations, filed an amicus brief supporting a legal challenge to the No Surprises Act dispute resolution process, according to a news release emailed to Becker’s. Five things to know: The groups are supporting a lawsuit filed by the American Hospital Association […]
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Telemedicine Providers Take Note – The No Surprises Act Is Effective January 1, 2022

  On December 27, 2020, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act, 2021.  In July and October 2021, respectively, the Department of Health and Human Services, the Department of Labor, the Department of the Treasury and the Office of Personnel Management (the Departments) issued two Interim Final […]
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Early Warning: Hospital Billing Errors Portend Bleakness

Hospitals across the nation are seeing lower profits, and it’s all because of a sudden tsunami of Medicare and Medicaid provider audits. Whether it be by Recovery Audit Contractor (RACs), Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), or otherwise, hospital audits are rampant. Billing errors, especially “supposed bundling,” are causing a high rate […]
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Claims Payment Transformation Benefits Payer, Providers, and Members

Payers, providers, and members can all benefit from transforming the manual and patchwork claims payment process to a digital environment that also automates claims data delivery. Payers, providers, and members are all central to the healthcare experience, working together to create a seamless, coordinated encounter from registration and the clinical visit to claims payment and […]
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CMS Releases 2022 Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]
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Lawmakers Seek Changes to No Surprises Act Implementation

More than a third of Representatives call on the federal government to revise No Surprises Act implementation, specifically around the independent dispute resolution process. A bipartisan group of 152 House members wrote to the secretaries of Health and Human Services, Treasury and Labor and urged them to amend the interim final rule (IFR) that will […]
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