Health Care Partner Khaled J. Klele and associate Connor Breza will be speaking at a USI webinar on Monday April 25, 2022 from 12:00 – 1:30 PM titled "Taking the Surprise out of the No Surprises Act."
HANYS appreciates that the departments are issuing technically complex regulatory guidance to meet the congressionally mandated NSA implementation deadline of Jan. 1, 2022, as demonstrated by the departments' decision to delay enforcement of the good faith estimates for insured patients and the advanced explanation of benefits requirements.
The Gordian Knot of Health Care: Navigating Anti-Kickback Laws to Incentivize Quality Care | Bressler, Amery & Ross, P C jdsupra.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from jdsupra.com Daily Mail and Mail on Sunday newspapers.
Monday, July 26, 2021
This week, I had two experiences, one in my practice and one in my personal life, that reiterated how challenging our health care system is. First, I had to tell a client that while I could get her 19-year-old son DDD services, there is nothing I could do to get him covered by Medicaid during the two-year waiting period for him to become Medicare eligible. That evening, my husband told me that he found out our health plan has stopped providing out-of-network coverage.
Out-of-Network Charges
Unexpected health care costs, especially from out-of-network providers, are a major problem for many Americans. Two-thirds of all bankruptcies filed in the United States are tied to medical expenses. Many of these result from surprise out-of-network charges. Researchers estimate that one of every six emergency room visits and inpatient hospital stays involves care from at least one out-of-network provider, resulting in surprise medical bills.
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In addition to providing funding for the federal government and for COVID-19 relief, the recently enacted Consolidated Appropriations Act, 2021, also includes legislation to safeguard patients from unexpected or “surprise” medical charges.
Effective January 1, 2022, the “No Surprises Act,” shields patients from otherwise unanticipated high costs of care delivered by medical providers that are not within a patient’s health plan network. Often, when an insured patient receives “out-of-network” care, generally on an emergent or unexpected basis, the patient’s health plan does not cover some or all of the costs of those services, leaving the patient to pay the balance of the bill.