CMS Releases No Surprises Act – Part II

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October 22, 2021

Randi A Brantner, MBA-HA
Vice President of Analytics
PARA HealthCare Analytics, an HFRI Company

On September 30, 2021, the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury released Part II of the “No Surprises Act” which was published in the Federal Register on October 7. The Act, which goes into effect on January 1, 2022, aims to protect patients from unexpected out of pocket costs resulting from surprise and balance billing.

Part II of the Act addresses plan coverage requirements, independent dispute resolution processes between the payers and providers, and details for how payers will determine patient cost-sharing responsibilities.

The Centers for Medicare & Medicaid Services (CMS) devotes a website to the No Surprises Act, Ending Surprise Medical Bills, which covers policies and resources, help with resolving payment disputes, and information on consumers rights and protections.

On September 31, CMS published a Fact Sheet, Requirements Related to Surprise Billing; Part II Interim Final Rule with Comment Period. Previously, CMS published a Fact Sheet covering Part 1, Requirements Related to Surprise Billing; Part I Interim Final Rule with Comment Period, on July 1, 2021.

PARA Healthcare Analytics can help

An essential component of the “No Surprises Act” is the ability for the provider to deliver pricing transparency to the consumer. Meeting the challenges of pricing transparency demands a systematic approach grounded in empirical evidence and a capable staff implementing proven solutions. PARA, a division of HFRI, a leader in accounts receivable recovery and resolution, can help you execute all steps necessary to comply with the transparency rule and improve patient satisfaction. To see how this solution would work for your hospital, click here to view a short demo.

Contact us today to learn more about how we can help your organization prepare for the pricing transparency requirement that is a critical component of the “No Surprises Act”.

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