This week, a Texas US Federal District Court granted a summary judgement in favor of the Texas Medical Association (TMA) setting aside and vacating the latest qualifying payment amount (QPA) Rule as violating the No Surprises Act (NSA). The Court … [Read more...] about Court Decision in TMA Lawsuit Good News for Providers
Federal Agencies Levy Substantial Increase in Administrative Filing Fees for NSA IDR in 2023
Late Friday afternoon on December 23, 2022 and well after most had begun celebrating their holiday, CMS quietly announced that it was increasing the non-refundable administrative fee for all IDR filings initiated under the No Surprises Act from $50 … [Read more...] about Federal Agencies Levy Substantial Increase in Administrative Filing Fees for NSA IDR in 2023
Texas Medical Association Files 3rd Lawsuit Challenging NSA Rule
On Wednesday, November 30, 2022 the Texas Medical Association (TMA) filed its third lawsuit against the Departments of Health and Human Services, Labor and the Treasury (the “Departments”) claiming that the final revised rule under the No Surprises … [Read more...] about Texas Medical Association Files 3rd Lawsuit Challenging NSA Rule
No Surprises Act Final Rule Issued…Good News for Providers
On Friday, August 19, 2022, the U.S. Department of Labor and related Federal regulatory agencies issued final No Surprises Act rules “only for certain issues critical to the implementation and effective operation of the Federal IDR process”. These … [Read more...] about No Surprises Act Final Rule Issued…Good News for Providers
No Surprises Act Remittance Advice Codes
Claims subject to the No Surprises Act (NSA) regulations have, over the last few months, begun to move through the revenue cycle process with new coding and regulatory compliance applicable for these claims. In preparation, on March 2, 2022, CMS … [Read more...] about No Surprises Act Remittance Advice Codes
Federal Departments File Notice to Appeal TMA Decision
Last Friday, the Defendants in the lawsuit filed by the Texas Medical Association (TMA) against the U.S. Department of Health and Human Services (HHS) and other Federal Departments, entered a notice that the federal departments collectively intend to … [Read more...] about Federal Departments File Notice to Appeal TMA Decision
California Law Confirmed by DMHC as Specified State Law Under NSA
The California Department of Managed Healthcare (DMHC) on March 21, 2022 issued an All Plan Letter with guidance to All Full-Service Commercial Health Care Service Plans clarifying the enforcement rules that apply between relevant, specified state … [Read more...] about California Law Confirmed by DMHC as Specified State Law Under NSA
Qualifying Payment Amount Presumption Invalidated | IDR Rule Rewrite Expected
Recently the U.S. Department of Labor issued a memorandum notifying the public and interested parties that the Qualifying Payment Amount (“QPA”) “presumption” has been invalidated as the result of a Federal Texas Court’s decision in a complaint filed … [Read more...] about Qualifying Payment Amount Presumption Invalidated | IDR Rule Rewrite Expected
Federal Texas Court Nixes Federal Agencies No Surprises Act Rule
On February 23, 2022, a Federal Court in Texas issued a decision and final judgment that certain parts of the Interim Final Rules Part II (“Rules”) adopted under the No Surprises Act (“NSA”) are invalid. Specifically, the Judge held that the … [Read more...] about Federal Texas Court Nixes Federal Agencies No Surprises Act Rule
Impact of the No Surprises Act on Patient Collection and Consumer Credit Reporting
The federal No Surprises Act (NSA) became effective January 1, 2022. The law is designed to protect patients from unexpected medical bills arising from emergency and most non-emergency services administered by out-of-network providers in certain … [Read more...] about Impact of the No Surprises Act on Patient Collection and Consumer Credit Reporting
