Feds Pursue Next Regs for Surprise Billing Law

In their continuing effort to implement the complex No Surprises Act, the 2020 law that seeks to prevent consumers from receiving surprise medical bills, federal regulators are now turning their attention to how providers and payers should inform insured individuals about the costs they may incur for procedures and purchases.

Specifically, the federal agencies with jurisdiction over the law and its implementation – the Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration – have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for services and items that are scheduled at least three days in advance to individuals who have health insurance.

Previous regulations have focused on the delivery of this information to uninsured and self-pay patients and those obtaining services from out-of-network providers.  At the time those regulations were proposed, providers and payers asked regulators to delay implementation of the law’s requirements for the provision of such information to insured patients so they could address the technical infrastructure needed to transfer data effectively and in a timely manner between and among providers and payers.

Now, regulators are asking providers and payers for input on how to do this through an RFI that asks detailed questions about many technical aspects of data-sharing among providers and payers.

Learn more this Federal Register notice.  Comments in response to the RFI are due by November 15.

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