Have you recently received a surprising medical bill or had your insurance coverage denials for a recommended treatment? Unfortunately, you’re not alone. A recent national survey by the Commonwealth Fund, a leading healthcare research organization, found that a significant number of insured Americans face these challenges. While many may choose not to contest these issues, […]
A new study by the health care system reveals a significant gap in consumer healthcare rights. Despite attempts to curb surprise medical bills, a large portion of insured Americans are still receiving unexpected charges. Adding to this problem is the high rate of coverage denials, leaving patients with substantial out-of-pocket costs and causing financial hardship […]
The federal No Surprises Act (NSA) has generated millions of complaints but serves to protect consumers from unexpected out-of-pocket healthcare costs, according to a new survey. AHIP, a U.S. health insurance trade group, and the Blue Cross Blue Shield Association (BCBSA) released a report that estimates the NSA prevents more than 1 million surprise bills […]
In a win for physicians, a federal court for the second time in less than two years has rejected the government’s attempt to implement an independent-dispute resolution process that Congress created with the 2020 “No Surprises Act.” The Texas Medical Association (TMA) and others challenged the final rule, showing how language in it still favored […]
One year ago, the United States marked a turning point for health care cost transparency with a new law aimed at helping Americans avoid unnecessary, unexpected medical debt. As of Jan. 1, 2022, health care providers and insurers are no longer allowed to sideswipe privately insured people with bills for out-of-network services. Experts say the […]
The AHA and American Medical Association yesterday filed a friend-of-the-court brief in support of a Texas Medical Association lawsuit claiming the revised independent dispute resolution process for determining payment for out-of-network services under the No Surprises Act skews the arbitration results in commercial insurers’ favor in ways that violate the compromise Congress reached in the […]
The federal No Surprises Act (NSA) prevented more than 2 million surprise medical bills for the first two months of 2022 – far more than federal regulators initially estimated. If the trend continues, the law will block more than 12 million surprise bills to patients this year, according to a projection from AHIP and the […]
The organization recommended CMS update the independent dispute resolution portal to improve communication between disputing parties and adjust the form field requirements. The Medical Group Management Association (MGMA) has asked CMS to update the federal independent dispute resolution (IDR) portal to streamline the arbitration process for determining an out-of-network payment rate for a surprise medical […]
The No Surprises Act came into effect in December 2021, potentially averting countless instances of unexpected billing claims within its initial two months of implementation. By May 24, 2022, the No Surprises Act had already thwarted over two million cases of surprise billing claims during its initial two-month span, as per a survey conducted by […]
The act seeks to reduce surprise billing through independent dispute resolution and incentives for providers to join health plan networks. The No Surprises Act used a couple of methods to reduce surprise billing, though the need for some modifications may remain, according to a resource from AHIP. “The real problem of surprise medical bills tended […]