Text of Agency ACA FAQs Part 71: No Surprises Act in Light of the Court Decision in TMA III, and Limitations on Cost Sharing Under the ACA (PDF)

Subscribe (Free) to
Daily or Weekly Newsletters

Post a Job

Featured Jobs

Participant Services Representative

BPAS
(Utica NY / Hybrid)

Retirement Plan Administrator

RetirementPlans.com, LLC
(Remote / Addison TX)

Participant Services Representative I - Health & Welfare

BPAS
(Spokane WA / Hybrid)

Senior Distributions Analyst

PCS Retirement
(Remote)

CDHP Consultant

BPAS
(Remote / Houston TX / NY / WA / Hybrid)

Relationship Manager - DC

Daybright Financial
(Remote)

Team Leader

Nova 401(k) Associates
(Remote)

Employee Benefits Attorney

Reid & Riege PC
(Hartford CT / Hybrid)

Benefits Analyst

Hydro
(Des Plaines IL / Hybrid)

View More Employee Benefits Jobs

Free Newsletters

“BenefitsLink continues to be the most valuable resource we have at the firm.”

-- An attorney subscriber

Text of Agency ACA FAQs Part 71: No Surprises Act in Light of the Court Decision in TMA III, and Limitations on Cost Sharing Under the ACA (PDF)
U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Department of the Treasury

[Official Guidance]
July 31, 2025

"[On] May 30, 2025, the Fifth Circuit granted a rehearing en banc, and vacated the Fifth Circuit's October 30, 2024 panel opinion. As a result, the ... district court's decision from August 24, 2023 continues to bind the Departments pending the Fifth Circuit's en banc decision....

Q1: How should plans and issuers calculate a QPA for purposes of patient cost sharing, disclosures with an initial payment or notice of denial of payment, and disclosures and submissions required under the Federal IDR process following the Fifth Circuit's order of May 30, 2025 in TMA III? ...
Q2: How should plans and issuers make disclosures about the QPA to nonparticipating providers, facilities, and providers of air ambulance services with an initial payment or notice of denial of payment, and in a timely manner upon request of the provider or facility? ...
Q3: What is the premium adjustment percentage for the 2026 plan year? ...
Q4: What is the maximum out-of-pocket limit for the 2026 plan year?"

MORE >>

Please click here to report this link if it is broken (for example, if you see a "404 File Not Found" error message after you click on the linked news item's title).

An important word about authorship: BenefitsLink® created this link to the news item, but we are not the news item's author (unless expressly shown above).