No Surprises Act: New Tools as Law Takes Effect

Feb. 2 Update: Watch a recording of the Jan. 20 American Medical Association webinar, “Implementing the No Surprises Act,” to learn from experts on No Surprises Act implementation, enforcement challenges, and the interaction between state and federal surprise billing requirements. Watch the webinar here, and continue to stay tuned to and Medicare bulletins for further updates.

Many provisions of the No Surprises Act (NSA), signed into law in late 2020, took effect Jan. 1. Since passage, the Centers for Medicare and Medicaid Services (CMS) issued two interim final rules to implement those provisions. CMS summaries and fact sheets on those rules and provisions are available here. In addition, a resource hub from the American Medical Association includes analysis on the law and implementation, as well as a toolkit.

While the ACC and other medical societies have expressed concerns about some requirements and are optimistic there could be refinements, clinicians must also comply with those and other provisions as they exist today.

Health care providers and co-providers are required to provide notice about the availability of good faith estimates (GFEs) for uninsured and self-pay patients on the provider’s website and on site. Clinicians and practice administrators may be interested in GFE templates offered by CMS here. The “Right to Receive a Good Faith Estimate of Expected Charges Notice” and “Good Faith Estimate Template” are the two relevant files. Such a notice of availability is required to be shared both orally and in writing, while the template could be used to build a requested GFE. A model notice of GFE availability and model GFE are available here.

Stay tuned to and Medicare bulletins for future updates.

Keywords: ACC Advocacy, Medicaid, Medicare, Medically Uninsured, Centers for Medicare and Medicaid Services, U.S.

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