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Cohen Howard

Federal Departments File Notice to Appeal TMA Decision

April 27, 2022 By Cohen Howard

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

Filed Under: Surprise Bill

California Law Confirmed by DMHC as Specified State Law Under NSA

April 12, 2022 By Cohen Howard

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

Filed Under: Surprise Bill

Qualifying Payment Amount Presumption Invalidated | IDR Rule Rewrite Expected

March 31, 2022 By Cohen Howard

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

Filed Under: Surprise Bill

Federal Texas Court Nixes Federal Agencies No Surprises Act Rule

February 28, 2022 By Cohen Howard

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

Filed Under: Uncategorized

Impact of the No Surprises Act on Patient Collection and Consumer Credit Reporting

February 23, 2022 By Cohen Howard

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

Filed Under: Uncategorized

Underpayment is a Major Concern for EDs under the NSA

February 4, 2022 By Cohen Howard

The No Surprises Act (NSA) took effect January 1, 2022.  This Federal legislation requires out-of-network providers to navigate new rules and adhere to specific timeframes in order to protect their rights to challenge under-reimbursed or denied … [Read more...] about Underpayment is a Major Concern for EDs under the NSA

Filed Under: Uncategorized

Plaintiffs Challenging the No Surprises Act Implementation Rules Find Support from the Industry and Most Notably Members of Congress

January 6, 2022 By Cohen Howard

As we welcome in 2022, the much-anticipated federal legislation, the No Surprises Act, has officially gone into effect to protect patients from surprise bills when receiving certain medical services mainly emergency care and non-emergency care … [Read more...] about Plaintiffs Challenging the No Surprises Act Implementation Rules Find Support from the Industry and Most Notably Members of Congress

Filed Under: Surprise Bill

NY Moves to Amend State Surprise Bill Law, Will Other States Follow Suit?

December 29, 2021 By Cohen Howard

The NY Department of Financial Services (DFS) recently announced it is amending the NY surprise billing law to “apply federal requirements to the NY IDR process.” As previously reported, in 2020, Congress adopted the No Surprises Act (NSA) which … [Read more...] about NY Moves to Amend State Surprise Bill Law, Will Other States Follow Suit?

Filed Under: Surprise Bill

Why so much controversy surrounding the No Surprises Act, Qualifying Payment Amount?

December 20, 2021 By Cohen Howard

What is the Qualified Payment Amount (QPA) and why is there so much controversy surrounding the interim rules announced by the departments with regard to its application in the Independent Dispute Resolution (IDR) process under the No Surprises … [Read more...] about Why so much controversy surrounding the No Surprises Act, Qualifying Payment Amount?

Filed Under: Surprise Bill

Healthcare Heavyweights File Lawsuit Over No Surprises Act IDR/QPA Rules

December 10, 2021 By Cohen Howard

As previously indicated, several lawsuits have been filed challenging the rules under the No Surprises Act regarding the presumption for Independent Dispute Resolution (arbitration) that the Qualified Payment Amount (QPA), the median in-network … [Read more...] about Healthcare Heavyweights File Lawsuit Over No Surprises Act IDR/QPA Rules

Filed Under: Surprise Bill

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