No Surprises Act

Surprise Bill Law’s “Good-Faith Estimate” to Challenge Providers

The requirement to give patients “good-faith estimates” of the costs associated with planned medical procedures will pose one of the biggest challenges to providers seeking to meet the implementation requirements of the 2020 No Surprises Act, which was intended to protect consumers from surprise medical bills, especially from providers not in their health insurers’ provider networks. Under the law’s implementing regulations, providers are often responsible for delivering good-faith estimates to their patients within 24 hours of scheduling a procedure. Eventually, the “convening provider” also will need to anticipate patients’ potential costs beyond the procedure itself and collect estimates for those [...]

iqtsupport2022-04-11T06:00:59-04:00April 11, 2022|hospitals|

Federal Health Policy Update for Thursday, April 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 7. Some of the language used below is taken directly from government documents. White House The administration is proposing to address a flaw in the Affordable Care Act often referred to as the “family glitch.” Under the ACA, people who do not have access to “affordable” health insurance through their jobs may qualify for a premium tax credit to purchase coverage on the ACA’s health insurance marketplaces. Current regulations define employer-based health insurance as “affordable” if the coverage for the employee [...]

iqtsupport2022-04-07T17:12:01-04:00April 7, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for Wednesday, March 2

The following is the latest health policy news from the federal government as of 3:00 p.m. on Wednesday, March 2. Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund FAQ has been updated with three modified questions that address 1099 forms and procedures involved in returning Provider Relief Fund money to the federal government. Find the three updates, all marked “Modified 2/25/2022,” on pages 6 and 8 of the Provider Relief Fund FAQ. Federal Response to Surprise Billing Regulation Court Decision Last week a federal court decision invalidated a major [...]

iqtsupport2022-03-02T17:41:03-05:00March 2, 2022|Accountable Care Organization, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

FEDERAL HEALTH POLICY UPDATE FOR FRIDAY, FEBRUARY 25

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, February 25. Some of the language used below is taken directly from government documents. Provider Relief Fund HHS made more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4100 providers across the country this week. According to HHS, approximately 86 percent of all Phase 4 applications have now been processed and the remaining applications will continue to be processed throughout early 2022. To date, HHS has distributed $11.5 billion of the $17 billion allocated [...]

iqtsupport2022-02-25T16:45:53-05:00February 25, 2022|ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, Medicare DSH, Medicare regulations, MedPAC|

Provider Groups Seek Delay in Surprise Billing Arbitration Rule

Health care provider groups are continuing their push to urge a federal court to suspend the portion of the recently implemented No Surprises Act regulation that governs the arbitration process when providers and payers cannot agree on payments. According to the providers, regulators make a policy argument in defense of their implementation of the 2020 surprise billing law, but they argue that policy is established by Congress, not regulators, and that the approach regulators have introduced is contrary to congressional intent as articulated in the law. Specifically, they maintain that the arbitration process establishes a benchmark rate rather than using [...]

iqtsupport2022-02-14T13:00:12-05:00February 14, 2022|Congress|

Federal Health Policy Update for Thursday, January 6

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, January 6. Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund reporting portal is now open for reporting period 2 and will remain open through March 31, 2022. Go here for more information about what organizations do and do not need to report and how to do so. The Provider Relief Fund web page offers updated information about what constitutes an allowable expense when reporting on the use of Provider Relief Fund [...]

iqtsupport2022-01-06T17:30:52-05:00January 6, 2022|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Monday, December 6

The following is the latest health policy news from the federal government as of 2:45 p.m. on Monday, December 6. Some of the language used below is taken directly from government documents. The White House The White House has published a plan outlining the steps the administration will take to combat the delta and omicron variants of COVID-19 in the coming months. The major components of this plan are boosters for all adults, vaccinations for children, expanded free home testing, stronger public health protocols for international travel, workplace protections, rapid response teams to help battle rising cases, and supplying treatment [...]

iqtsupport2021-12-06T17:23:36-05:00December 6, 2021|Accountable Care Organization, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for Wednesday, December 1

The following is the latest health policy news from the federal government as of 3:00 p.m. on Wednesday, December 1. Some of the language used below is taken directly from government documents. Omicron Variant The CDC has confirmed the first case of the COVID-19 omicron variant on U.S. soil. Learn more from this CDC news release. Health Care Employee Vaccine Mandate COVID-19 A federal court has issued a preliminary injunction blocking enforcement of the federal government’s requirement that health care workers receive COVID-19 vaccines by December 6. Find the court’s ruling here. The ultimate ruling will be made by a [...]

iqtsupport2021-12-01T17:37:13-05:00December 1, 2021|Center for Medicare and Medicaid Innovation, CMMI, Coronavirus, COVID-19, MedPAC, Telehealth|

Federal Health Policy Update for Tuesday, November 23

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, November 23. Some of the language used below is taken directly from government documents. The White House The White House has posted a transcript of the November 22 press briefing given by its COVID-19 response team and public officials. Go here for the slides presented during that meeting. Provider Relief Fund HHS announced that it has begun distributing $7.5 billion in American Rescue Plan rural payments to providers and suppliers that serve rural Medicaid, Children's Health Insurance Program (CHIP), and Medicare beneficiaries. [...]

iqtsupport2021-11-23T17:27:12-05:00November 23, 2021|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Wednesday, October 6

The following is the latest health policy news from the federal government as of 2:15 p.m. on Wednesday, October 6. Some of the language used below is taken directly from government documents. Provider Relief Fund: Reminder That Applications Are Now Being Accepted The Health Resources and Services Administration (HRSA) has opened its portal for providers to apply for $25.5 billion in health care relief funds, including $8.5 billion in American Rescue Plan resources for providers that serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program and $17 billion for Provider Relief Fund Phase 4 grants for [...]

iqtsupport2021-10-06T19:24:30-04:00October 6, 2021|340b, Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, MedPAC|