Helaine I. Fingold, Member of the Firm in the Health Care & Life Sciences practice, was quoted in Law360 Healthcare Authority in “No Surprises Act's New Rule Hands Win to Providers,” by Yeji Jesse Lee. (Read the full version – subscription required.)
Following is an excerpt:
A long-awaited update to the No Surprises Act includes a slew of technical changes to dispute resolutions that attorneys say add up to a win for providers seeking to navigate a complex process.
The final rule announced Thursday updates the No Surprises Act's arbitration system – the framework through which providers and payors can dispute out-of-network reimbursement rates - by slashing the administrative fee from $115 to $15.
It also increases the number of claims that can be batched together in a single dispute and rolls out a new centralized platform for disputes, among other changes. …
Fingold, who was at CMS for around 15 years before joining the firm, predicted that the changes will force payors to be more organized and responsive to disputes.
While that will mean more work for payors, Fingold said, it's not all bad news.
"The goal is to increase the robustness of the information that is at the front end to help people clarify whether the dispute should even be in the IDR process," she said. That will help weed out ineligible claims earlier, and ultimately benefit payors.
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