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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

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

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

For years, insurance companies have operated networks of physicians and facilities which they pair with company benefit plans and their own insurance policies to facilitate “in-network” coverage for members.  Physician networks are marketed by … [Read more...] about What’s So Great About Being An In-Network Provider Under the No Surprises Act

The Women's Health and Cancer Rights Act (WHCRA), passed by Congress in 1998 and adopted as part of the Employee Retirement Income Security Act (ERISA), was enacted to protect women from abuses related to health plan coverage for a mastectomy and … [Read more...] about Breast Reconstruction and the Women’s Health and Cancer Rights Act (WHCRA)

The Departments of Health & Human Services (HHS), Labor, and the Treasury together with the Office of Personnel Management (OPM) issued, on September 10, 2021, a second set of regulations under the No Surprises Act (NSA). The proposed rule … [Read more...] about Enforcement Provision of the No Surprises Act (NSA) Proposed Rule Issued

The New Jersey Department of Banking and Insurance (‘DOBI’) has published statistics tracking the number of Surprise Bill cases submitted to Maximus Federal, the DOBI contractor handling arbitration cases under the New Jersey Out-of-Network Consumer … [Read more...] about Out-of-Network Arbitrations Yield Favorable Results For Providers

During these unprecedented times, many elective surgeries have been suspended to allow for COVID-19 patients to receive necessary care in their time of need. This has halted most plastic surgeries for the time being, but plastic surgeons are not … [Read more...] about Elective surgeries may have been ceased, but plastic surgeons are not resting amid coronavirus pandemic

On November 20, 2018, The New Jersey Department of Banking and Insurance (“DOBI”) released Bulletin No. 18-14 (the “Bulletin”) relating to Implementation of P.L. 2018 C. 32 (N.J.S.A. 26:2SS-1 to -20) Out-of-Network Consumer Protection, Transparency, … [Read more...] about NJ Surprise Bill Regulatory Alert — DOBI Publishes Implementation Bulletin