Overview of the Texas Medical Association Lawsuits over the No Surprises Act
Since implementation of the No Surprises Act (NSA) on January 1st, 2022, there have been four lawsuits brought on by the Texas Medical Association (TMA). Interesting that the TMA is more vocal and active legally and supportive of physicians in America than the American Medical Association (AMA). Not sure why anyone would pay dues to […]
New Compliance Updates. BuildMyHealth’s ‘Guide to Survive.’ Running Your Medical Practice in 2023
What is the No Surprises Act The No Surprises Act (NSA) went in to effect January 1st 2022. For those unfamiliar… the No Surprises act is an effort to reduce the number of surprise bills that patients are faced with after their procedure. Even after a year of implementation the Act is still largely overlooked […]
Convening Provider rule delayed
FAQS ABOUT CONSOLIDATED APPROPRIATIONS ACT, 2021 IMPLEMENTATION – GOOD FAITH ESTIMATES (GFES) FOR UNINSURED (OR SELF-PAY) INDIVIDUALS – PART 3 December 2, 2022 Set out below are Frequently Asked Questions (FAQs) regarding implementation of Section 112 of Title I (the No Surprises Act (NSA)) of Division BB of the Consolidated Appropriations Act, 2021, and implementing […]
We have the data! Converting Machine Readable Files to Human Readable Files!
The Trump era Transparency in Coverage (TiC) rule released in 2020 focused on insurance companies and require that insurers make machine readable files (MRFs) of negotiated in-network rates and out-of-network allowables publicly available on their websites by July 1st, 2022. Going one step further, by January 1st, 2023, plans must make cost-sharing information available for […]
Final Rule on Qualifying Payment Amount (QPA) for out-of-network services “downcoded” to in-network rates
Fact Sheet U.S. Department of Labor Employee Benefits Security Administration August 19, 2022 REQUIREMENTS RELATED TO SURPRISE BILLING: FINAL RULES On August 19, 2022, the U.S. Departments of Health and Human Services, Labor, and the Treasury (the Departments) released final rules titled “Requirements Related to Surprise Billing: Final Rules.” These rules finalize provisions related to […]
Frequently asked questions for providers about the No Surprises Rules – Part 1
April 6, 2022 The Consolidated Appropriations Act of 2021 established several new requirements to protect consumers from surprise medical bills. These requirements are collectively referred to as “No Surprises” rules. These requirements generally apply to items and services provided to consumers enrolled in group health plans, group or individual health insurance coverage, and Federal Employees […]
FAQS about Consolidated Appropriations Act, 2021 implementation – Good Faith Estimates (GFE) for uninsured (or self-pay) individuals – Part 2
April 5, 2022 Set out below are Frequently Asked Questions (FAQs) regarding implementation of Section 112 of Title I (the No Surprises Act (NSA)) of Division BB of the Consolidated Appropriations Act, 2021 (CAA 2021), and implementing regulations published in the Federal Register on October 7, 2021 as part of interim final rules with comment […]
Founder/CEO, Jonathan Kaplan and US Senator Bill Cassidy pen op-ed in Newsweek
The No Surprises Act, a bipartisan effort to reduce the number of surprise medical bills, went into effect on January 1. As significant as this legislation is—surprise bills are one of the biggest drivers of medical bankruptcy in America—the act is still being overlooked. This legislation remains unfamiliar to those it affects most, specifically […]
Pick your poison! Two No Surprises Act webinars to choose from
WEBINAR 1: The No Surprises Act and how it applies to ALL plastic surgeons March 9th, 4pm EST/3pm CST/2pm MST/1pm PST Joint webinar with the American Society of Aesthetic Plastic Surgery (ASAPS) If you miss the live webinar, you can still click here to watch the recording. WEBINAR 2: The No […]
Standard Notice Regarding Patient Protections Against Surprise Billing
PDF of Disclosure Notice Regarding Patient Protections Against Surprise Billing posting Must be posted in office/facility where scheduling occurs and on website