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The No Surprises Act is a significant change to how healthcare coverage is handled and billed. In general, it eliminates balance billing in three typical areas:
- A patient is brought to an emergency room in an out of network hospital
- A patient is transported by air ambulance
- A patient is being cared for at an in-network hospital but, unbeknownst to him or her, a physician or service that is out of network provides care.
To understand the Act more fully, we spoke with Brian Stimson, Partner, Arnall Golden Gregory, who will be leading the session The All Surprises Act: Avoiding Compliance Pitfalls and Responding to Administrative Enforcement Actions under the Surprise Billing Laws at the 2024 HCCA Compliance Institute.
As he explains, there is a two-tiered enforcement structure to the law, with both individual states and the federal government involved.
Compliance teams looking to ensure their organizations are complying need to pay close attention to patient complaints. These can be a tip off to improper balance billing and a red flag of systemic issues. Be extra alert if a patient comes to them, and it can even be good to check social media for reports of wrongful billing.
Listen in to learn more, and then join us in Nashville, April 14-17, for the HCCA Compliance Institute.