UnitedHealthcare has filed suit against Radiology Partners and its Arizona-based affiliate, Sonoran Radiology, accusing the company of abusing the No Surprises Act’s independent dispute resolution (IDR) process and funneling “millions into the pockets of its private-equity owners.”
According to Becker's Payer Issues, the case...
Last week, the Biden administration announced a proposed rule through the U.S. Department of Health and Human Services (HHS), Labor and the Treasury Department that would implement the independent dispute resolution process (IDR process) outlined by the No Surprises Act, which seeks to protect patients and medical services consumers from...National News
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) have paused the independent dispute resolution process for payment disputes between providers and insurers following a federal court decision invalidating part of the law.
The U.S. District Court for the Eastern District of...National News
Despite growing evidence of the harm caused by medical debt, hundreds of U.S. hospitals maintain policies to aggressively pursue patients for unpaid bills, using tactics such as lawsuits, selling patient accounts to debt buyers, and reporting patients to credit rating agencies, a KHN investigation shows.Byline: Noam N. Levey
December...National News
On Tuesday, the Medical Group Management Association (MGMA) released its annual regulatory burden report, which analyzes the regulatory burden placed upon providers. This year, the report highlights the issues with prior authorization, the Medicare Quality Payment Program and the No Surprises Act.
The report breaks down the responses...
The Texas Medical Association (TMA) will now lead the charge against the federal government's rules for implementing the No Surprises Act, which aims to curb surprise bills levied on patients who unknowingly or in times of emergency receive care from providers who are out-of-network for their insurance coverage.
Last week, the...
The American Hospital Association (AHA) and the American Medical Association (AMA) will end a legal challenge to federal rules on surprise billing arbitration but intend to file another suit in the future.
The suit was filed against the federal government last December, with the aggrieved parties arguing that the surprise billing...
Last Friday, the U.S. Departments of Health and Human Services, Labor and Treasury issued a joint final rule that rectifies issues with the implementation of the No Surprises Act, a law that aims to curb surprise billing practices.
The rule defines the processes for payers and providers to settle payment for services provided that...
American Health Insurance Plans (AHIP) teamed up with the Blue Cross Blue Shield Association (BCBSA) to provide the data on commercially insured patients in the first two months of 2022.
Most of the No Surprises Act's provisions took effect at the beginning of 2022, applying to those enrolled in health insurance coverage or a group...
There were a couple of legal challenges announced this week for hospitals and health systems on the concern of paying. Hospitals accused of overcharging for procedures is a common theme in two cases while Louisiana accused UnitedHealth Group of inflating drug prices to its Medicaid program via Optum Rx by billions.
The Colorado State...
The No Surprises Act, a law that aims to protect Americans covered by private health plans from receiving surprise medical bills relating to emergency services or non-emergency services from out-of-network providers at in-network facilities, has been met with trouble since its implementation at the beginning of the year.
In February,...National News
A federal judge for the eastern district of Texas struck down a controversial aspect of the No Surprises Act last week, leaving in place protections for patients but siding with providers that a qualifying payment amount is not the appropriate out-of-network rate.
The No Surprises act formally went into effect on January 1 of this...National News
The No Surprises Act, which intends to end the practice of surprise billing by banning most surprise bills from out-of-network providers went into effect on January 1. The rule will effect not only all emergency care billing and "most" nonemergency billing but will also require uninsured patients receive overviews of anticipated costs...National News
On Thursday, an interim final rule was passed laying out the new independent dispute resolution (IDR) process for the surprise billing law. The No Surprises Act, passed in December 2020, bans surprise billing for out-of-network emergency and non-emergency services, limits cost-sharing to in-network rates, and creates the new IDR process....
Last Thursday, the U.S. Department of Health and Human Services (HHS) issued an interim final rule that aims to protect consumers from surprise and balance billing practices and restricting out-of-pocket costs. Surprise billing was a major campaign concern for both presidential candidates and the Biden Administration is acting on...
Along with a $1.4 trillion omnibus spending bill, Congress finalized and President Trump signed the second largest piece of emergency relief in the country's history. After nine months of wrangling, the 5,600 page, $900 billion pandemic relief package includes a surprise billing ban with a 2022 roll-out, addresses concerns from...National News
Last week, President Donald Trump issued yet more executive orders regarding healthcare. This comes in addition to a number of other pharmaceutical-focused orders signed by the president in recent months and comes before the election as well as the upcoming Supreme Court decision on the constitutionality of the Affordable Care...National News
Despite 2020 presidential candidate debates and lawmakers' crusade on the healthcare industry's business model, pharmaceutical companies, hospitals and insurance companies fared quite favorably as billions in tax breaks line their pockets ahead of the holidays.
Former CMS Administrator Andy Slavitt told the Washington Post,...Arizona News
The two private-equity backed companies own physician practices and staff emergency rooms across the country and oppose what it claims are, "insurance-industry backed proposals for government rate setting," to solve the problem of surprise medical bills.
The group, Doctor Patient Unity, has spent more than $28 million on television,...National News
On Monday, June 24, President Trump directed a slew of federal agencies to start working on several transparency issues, including forcing hospitals and payers to reveal privately negotiated rates. Providers will also be expected to provide patients with an estimate of their out-of-pocket costs before a procedure.
Elected in part...
