No Surprises Act

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Envision’s Bankruptcy Provides Insight Into All That is Ailing The Healthcare Industry

The increase in bankruptcy filings that restructuring professionals have been expecting is now arriving.  With rising inflation, increased interest rates, tightening credit markets, labor shortages and supply chain disruptions, we are starting to see a dramatic increase in filings.  Last week the American Bankruptcy Institute noted that commercial Chapter 11 filings increased 105% in May … Continue Reading

CMS Instructs IDR Entities Not To Issue New Payment Determinations Pending Further Guidance from Departments

As we recently reported, on February 6, 2023, Judge Kernodle of the United States District Court for the Eastern District of Texas issued a decision in Texas Medical Association v. U.S. Dep’t of H.H.S., Case No. 6:22-cv-372 vacating certain portions of the regulations governing the dispute resolution process governing reimbursement disputes under the No Surprises … Continue Reading

District Court Declares Portion of Regulations Governing NSA’s Dispute Resolution Process Invalid

On February 6, 2023, Judge Kernodle of the Eastern District of Texas once again vacated certain provisions of an agency rule as inconsistent with the No Surprises Act (the “NSA”).  Almost a year ago, Judge Kernodle issued a similar decision, which we blogged about.  Both decisions concerned the independent dispute resolution (“IDR”) process the NSA … Continue Reading

IDR Payment Disputes are Far Outpacing Projections, Creating Backlogs

The No Surprises Act (the “NSA”), which was enacted as part of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260) provides protections to privately insured patients against “surprise billing” with respect to emergency services, non-emergency services provided by out-of-network providers at in-network health care facilities, and air ambulance services furnished by out-of-network providers.  As part … Continue Reading
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