Published by: Administrator
Recently the Departments of Health and Human Services, Labor, and the Treasury issued an interim final rule (the “IFR”) concerning the federal No Surprises Act. Although the hope was that the IFR would provide clarity as to the requirements and dispute resolution programs under the No Surprises Act, it left many questions unanswered and revealed a considerable hindrance to out-of-network providers securing fair and reasonable reimbursement.
In particular, the presumption that the qualifying payment amount (the “QPA”), defined as the plan’s median in-network rate for the applicable geographic area, serves as the primary obstacle to overcome before fair and reasonable reimbursement will be securable. Notably, this position as set forth in the IFR, contradicts Congressional intent, as explained in the recent letter from the U.S. House of Representative’s Committee on Ways and Means.
Are you wondering how the No Surprises Act means for your business? You are not alone. There are many questions and not many answers to common questions about this new law. While there may be a lot of negative attention on the topic, there are some key points of positive changes and how this can improve processes and even improve revenue.
Learn about Section-by-Section Review of the Legislation and its Impact on Provides/ Facilities.
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