The No Surprises Act (“Act” or “NSA”), included within the Consolidated Appropriations Act, is a massive piece of COVID-19 relief legislation signed into law in late 2020. Effective January 1, 2022, the Act created a significant, new set of federal surprise or balance billing prohibitions and disclosure requirements that overlay an already inconsistent and confusing patchwork of state laws and administrative rules on the same subject. The three federal agencies responsible for implementing the NSA have issued the first set of rules fleshing out the law, but many questions remain unanswered and more rules are forthcoming.
Health care facilities, providers, and ancillary service entities that support hospital in-patient, out-patient, and emergency operations are scrambling to figure out what the new federal law means for them. Epstein Becker Green’s surprise billing team is hard at work to make sense of the Act and design tailored, “operationalized” compliance programs for multiple clients from different disciplines and industries. The firm’s experience in this area is at once hardened by years of solving balance and surprising billing issues at the state level and rededicated to deciphering the complex interaction between state law and the new federal law.
Epstein Becker Green is equipped to assist health care clients in meeting their obligations under the Act and relevant state laws. Our services include:
- Providing specific and “operationalized” guidance to providers, facilities, and health plans on complying with the Act, including its challenging interaction with state balance billing laws.
- Analyzing the impact and scope of the Act on billing for ancillary services provided outside of, but associated with, a hospital visit.
- Advising providers on opportunities to influence the substance and operation of the Act by making strategic, concrete comments to federal agencies during the rule-making process.
- Helping startup providers strategize reimbursement methodologies for their product that ease NSA compliance burdens and promote fair reimbursement rates.