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View More Strafford Webcasts and Conferences

New Federal Surprise Billing Rules Compliance: Navigating the Complex and Far-Reaching Legislation

Strafford

Oct. 14, 2021
Recorded Online
Webcast

This CLE webinar will guide healthcare counsel on the new No Surprises Act. The panel will discuss what healthcare providers and their counsel need to know to understand the new interim rules. The panel will discuss how CMS will determine the qualifying payment amount and the impact of that determination on the financial relationships between providers and patients and payers. The panel will also discuss the notice and consent requirements under the new rule as well as the issues on which CMS is focusing.

Description

The No Surprises Act, which goes into effect on Jan. 1, 2022, is designed to protect patients from unexpected or "surprise" medical bills and seeks to improve price transparency by providing consumers greater access to information. Not surprisingly, the Act imposes significant new requirements on providers and group health plans to achieve these goals.

The interim final rule prohibits surprise billing for emergency services provided by an out-of-network (OON) provider. The rule requires all non-emergency services provided by OON providers at innetwork facilities to be treated as in-network services, except where the insured individual has consented to the OON service.

Because many states had passed laws protecting patients against surprise medical bills before the No Surprises Act was passed, the interim final rule calls for state law to be used to determine the recognized amount and the OON rate if a method for doing so is provided. If the state law is to apply, it must apply to the health plan, the nonparticipating provider, and the service in question.

Listen as our authoritative panel of healthcare attorneys examines what healthcare providers and their counsel need to know in understanding the new interim rules. The panel will discuss how CMS will determine the qualifying payment amount and the effect of that determination on the financial relationships between providers and patients and payers. The panel will also discuss the notice and consent requirements under the new rule and the issues on which CMS is focusing.

Outline

  1. New surprise billing rules
  2. Qualifying payment amount
    1. CMS determination
    2. Impact of determination on the financial relationship between providers and patients and payers
  3. Notice and consent requirements
  4. Best practices to ensure compliance

More Information, How to Register

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