The No Surprises Act, which creates cost transparency for patients and protects against balance billing, took effect Jan. 1, 2022. It has shifted care and billing rules for ASCs and hospitals, and has been extremely controversial over the last two years.
Here seven updates on the No Surprises Act two years later:
1. An appeals court has partially revived Daniel Haller, MD, and the surgeons at Rockville Centre, N.Y.-based Long Island Surgical PLLC's lawsuit challenging the No Surprises Act as unconstitutional.
2. The federal government issued a final rule Dec. 18 setting the fee to enter the No Surprises Act arbitration process at $115. The rule mandates that the administrative fee amount will be established no more than once per calendar year.
3. Healthcare companies and their investors are looking at maturing debt due to concern over the act. Bloomberg alleges that the act has contributed to the bankruptcies of health-related companies, including Nashville, Tenn.-based Envision Corp.
4. Federal officials have issued proposed changes to the No Surprises Act's independent dispute resolution process.
5. Federal departments sought to raise the administrative fee to enter the No Surprises Act arbitration process from $50 to $150 in 2024.
6. From Aug. 25 to Sept. 21, CMS temporarily suspended all federal IDR processes in response to a Texas judge's latest ruling in a series of lawsuits challenging provisions of the No Surprises Act.
7. Missouri Rep. Jason Smith, chairman of the House Ways and Means Committee, held a hearing alleging that the federal government's flawed implementation of the No Surprises Act has made the problem it intended to fix worse. He said the flawed implementation is "resulting in more medical providers no longer covered under health insurance networks."