The No Surprises Act: A Look at the First Round of Federal Regulations on Surprise Billing

Health Care and Life Sciences Client Alert

On July 13, 2021, the Biden administration (“Administration”) officially published the “Requirements Related to Surprise Billing; Part I”—its first regulatory response to the enactment of the No Surprises Act (“NSA”)—as an interim final rule with a request for comments (“First NSA Rule”) in the Federal Register. Issued by the U.S. Office of Personal Management and the Departments of Health and Human Services, Labor, and the Treasury, the First NSA Rule leads the series of regulations the Administration expects to issue to implement the NSA, which goes into effect on January 1, 2022. The Administration initially released the First NSA Rule to the public as a pre-issuance on July 1, 2021, to meet the first regulatory deadline imposed by the NSA. A copy of the official Federal Register version of the First NSA Rule can be obtained at the following link: https://www.federalregister.gov/documents/2021/07/13/2021-14379/requirements-related-to-surprise-billing-part-i. Comments are due September 7, 2021.

Through the NSA, Congress established a new federal program that includes new federal limitations on patients receiving surprise bills, specifically on when it is appropriate or inappropriate for a non-participating provider to bill a patient with commercial insurance coverage above the in-network patient out-of-pocket amount for covered emergency services provided by that non-participating provider or certain covered nonemergency services provided by that non-participating provider at a participating facility.

In this Client Alert, we:

  1. provide a high-level overview of the NSA provisions addressed in the First NSA Rule,
  2. identify the many issues on which the Administration specifically requests comment within the First NSA Rule, and
  3. list the NSA provisions that will likely be addressed in future rulemaking and guidance issuances and the expected timing for such issuances.

Click here to download the full Client Alert in PDF format.

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This Client Alert was authored by Alexis Boaz, Helaine I. Fingold, Robert R. Hearn, Jonah D. Retzinger, Lynn Shapiro Snyder, and Lesley R. Yeung.* For additional information about the issues discussed in this Client Alert, please contact one of the authors or the Epstein Becker Green attorney who regularly handles your legal matters.

*Chloe Hillard, a Summer Associate in Epstein Becker Green’s Washington, DC, office, contributed to the preparation of this Client Alert.