Surprise Bill

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

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?

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?

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

Concerns About the Federal No Surprises Act: Interim Final Rules According to an article published by KHN, the federal agencies responsible for issuing the regulations for the implementation of “the No Surprises Act” (NSA) have publicly … [Read more...] about Challenges to the No Surprises Act’s Interim Final Rules, Part II, Fall on Deaf Ears

The No Surprises Act (NSA) becomes effective on January 1, 2022 and will apply to virtually all commercial medical claims covered by ERISA, Non-ERISA, self-insured and fully insured plans for (1) emergency care performed by an out-of-network … [Read more...] about Does State Law Now Preempt ERISA Under The No Surprises Act (NSA)

Congratulations to the Cohen Howard Surprise Bill team who recently handled a New Jersey Surprise Bill claim for our client, an out-of-network plastic surgeon. Following submission of our arbitration brief, the arbitrator determined our client’s … [Read more...] about Finding the Sweet Spot Under Surprise Bills