Tag: balance billing

Report Shows Dispute Resolution Process in No Surprises Act Favors Providers

Last month, the Biden administration reported on independent dispute resolution (IDR) cases resolved under the No Surprises Act in the first half of 2023. In a new post for the Commonwealth Fund, CHIR’s Jack Hoadley and Kevin Lucia analyze the IDR data and what it means for patients, providers, payers, and health care costs.

The One Year Anniversary of 988: A Roadmap for States Seeking to Expand Access to Behavioral Health Crisis Services

One year ago, the U.S. transitioned to a new, three-digit nationwide number for suicide prevention and mental health crisis response services. In their latest expert perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies project, JoAnn Volk and Sabrina Corlette provide a roadmap for states seeking to expand access to behavioral health crisis services, spotlighting Washington State’s comprehensive approach.

Providers Challenge Payments In ‘No Surprises’ Act Dispute Resolution Process

Under the No Surprises Act, consumers are held harmless beyond in-network cost sharing when they receive certain kinds of out-of-network care. In these scenarios, to determine the provider’s payment, payers and providers may enter independent dispute resolution (IDR). Recently, federal agencies released an initial report on the No Surprises Act’s IDR process. In a post for Health Affairs Forefront, CHIR experts Jack Hoadley and Kevin Lucia analyze the new report and discuss what it suggests about the No Surprises Act.

The No Surprises Act Final Rule: Implications for State Regulators

The Biden administration has published its final rules governing the independent dispute resolution process outlined in the No Surprises Act. In a new Expert Perspective for the State Health & Value Strategies project, CHIR’s Jack Hoadley, Kevin Lucia, and JoAnn Volk review the rule and its implications for state regulators.

CHIR Interactive Map Highlights New Details on No Surprises Act Enforcement

The No Surprises Act (NSA) went into effect this year, providing new protections against surprise medical bills for patients who receive unanticipated out-of-network care. CHIR has analyzed state NSA implementation and enforcement schemes and published an interactive map for the Commonwealth Fund, providing details about policies such as state enforcement strategies and patient-provider dispute resolution. In the newest iteration of the map, CHIR added updates on state payment determination mechanisms and protections against surprise ground ambulance bills.

Filling a Gap in the No Surprises Act: What are States Doing to Protect Consumers from Out-of-Network Ground Ambulance Bills?

In January, the No Surprises Act will provide landmark protections against surprise billing, but ground ambulance services are excluded from the new safeguards. In a post for the Commonwealth Fund’s To the Point blog, CHIR experts discuss challenges related to ground ambulance reimbursement and state strategies for protecting consumers from surprise bills.

The No Surprises Act Interim Final Rule on Dispute Resolution, Uninsured Protections, and External Review: Implications for States

Last month, the Biden administration published a third rule implementing the No Surprises Act, the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. The interim final rule (IFR) provides details on the independent dispute resolution process, protections for uninsured patients, and more. In a new Expert Perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies program, CHIR experts provide a summary of the IFR, identifying implications and considerations for states.

The No Surprises Act Proposed Rule on Air Ambulances and Enforcement: Implications for States

This month the Biden administration released a second rule implementing the No Surprises Act, the new federal law banning balance bills in certain care settings and circumstances starting in 2022. In an Expert Perspective for the State Health & Value Strategies project, CHIR experts JoAnn Volk and Sabrina Corlette review provisions of the proposed rules of particular import to state-based marketplaces and state insurance regulators.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.