News & Analysis as of

Employee Retirement Income Security Act (ERISA) Surprise Medical Bills

Mandelbaum Barrett PC

The No Surprises Act: A Look at What Dentists Need to Know

Mandelbaum Barrett PC on

The Federal No Surprises Act (“NSA”) was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act of 2021. Since its enactment, the NSA has been supplemented on two occasions by regulations which...more

Hall Benefits Law

The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors

Hall Benefits Law on

Benefits costs continue to increase globally, and in the midst of high inflation and potentially a recession, executives are exploring cost effective methods to manage their self-insured health plans without compromising the...more

Snell & Wilmer

2023 End-of-Year Plan Sponsor “To Do” Lists (Part 1) Health and Welfare

Snell & Wilmer on

We are pleased to present our annual End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 covers year-end health and welfare plan issues....more

Jackson Lewis P.C.

Ohio’s Surprise Billing Law – Impact on Health Plans

Jackson Lewis P.C. on

Ohio’s Surprise Billing Law, R.C. § 3902.51, became effective January 12, 2022, but its impact on health plans is still evolving. The law strives to prevent patients from receiving and paying surprise medical bills,...more

Greenbaum, Rowe, Smith & Davis LLP

Texas Court Sides with Challengers to Independent Dispute Resolution Process Under No Surprises Act

What You Need to Know- •A federal court sided with challengers in finding that certain CMS rules conflict with the federal No Surprises Act, pressuring healthcare providers to lower their offers in arbitration. ...more

Snell & Wilmer

An Interesting Intersection: No Surprises Act Claims and the New Fee Disclosure Requirements for Group Health Plans

Snell & Wilmer on

As reported in our January 7, 2022 SW Benefits Blog “The DOL Asks and Answers Questions About the New Welfare Plan Fee Disclosure Rules,” group health plans must now comply with the ERISA Section 408(b)(2) disclosure...more

Mintz - Employment Viewpoints

Health Plan Transparency and the Case for Welfare Plan Fiduciary Committees

The Consolidated Appropriations Act, 2021 (the “Act”) adopted a series of transparency requirements that apply to employer-sponsored group health plans. These transparency rules impose a series of new and complex obligations...more

Verrill

Surprise Medical Bills: Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

Verrill on

The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more

King & Spalding

Don’t Be Surprised – The No Surprises Act Takes Effect January 1, 2022

King & Spalding on

The No Surprises Act (the Act), enacted December 27, 2021, will take effect on January 1, 2022. The No Surprises Act puts into place important patient protections from surprise medical bills, while imposing significant...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

HHS Proposes Air Ambulance Reporting Details Beginning in 2022

Employer-sponsored health plans can add air ambulance claims reporting to the list of required disclosures that will go into effect in the next several years. Under proposed regulations published September 16, 2021, by...more

Groom Law Group, Chartered

Surprise! Tri-Agencies Meet Deadline with First Set of Surprise Billing Rules, With More to Come

On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (“DOL”) (collectively, the “Departments”), released the interim final...more

Holland & Knight LLP

HHS Issues Interim Final Rule Implementing Certain Provisions of the No Surprises Act

Holland & Knight LLP on

The U.S. Departments of Health and Human Services (HHS), Labor and Treasury, along with the Office of Personnel Management, on July 1, 2021, issued a much-anticipated Interim Final Rule with Comment Period (IFC) –...more

Greenbaum, Rowe, Smith & Davis LLP

Federal “No Surprises Act” Brings National Oversight Of Unexpected Billing For Healthcare Services

In the waning days of Donald Trump’s administration, the federal government passed the “No Surprises Act,” which becomes effective January 1, 2022. Like many recent state laws, the legislation is aimed at protecting patients...more

Hogan Lovells

No Surprises Act prohibits balance billing, creates arbitration process for out-of-network providers

Hogan Lovells on

Effective January 1, 2022, the “No Surprises Act” signed into U.S. law as part of H.R. 133, “Consolidated Appropriations Act, 2021,” implicates (1) emergency services provided by non-participating providers at participating...more

Locke Lord LLP

Surprise Medical Billing – Changes to Law Will Have a Significant Impact on Group Health Plans

Locke Lord LLP on

On December 21, 2020, Congress passed the Consolidated Appropriations Act, 2021, which included a $900 billion COVID-19 relief and stimulus package and a new set of rules intended to address “surprise” medical billing. The No...more

Proskauer Rose LLP

No Surprises: Congress Enacts Surprise Bill Law and Adds Mandatory Billing Transparency

Proskauer Rose LLP on

The recently enacted Consolidated Appropriations Act, 2021 (the “Act”) not only funds the government and provides further relief in regard to the impact of the COVID-19 pandemic, but it also adopted a number of new...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Surprise Medical Billing Protections Coming for Participants in 2022

Beginning in 2022, employer-sponsored health plans will be required to pay providers certain emergency and out-of-network charges that would have otherwise been balance billed to participants. That is the centerpiece of...more

Seyfarth Shaw LLP

New Surprise Billing Legislation and Rules Go Into Effect on January 1

Seyfarth Shaw LLP on

New legislation passed in the 2019 session of the Texas Legislature, SB 1264, went into effect on January 1, 2020. The statute protects Texas residents from so-called surprise billing, where patients receive costly medical...more

King & Spalding

House Drug Pricing Proposal Released; Surprise Billing Legislation Stalls

King & Spalding on

On September 19, 2019, House Speaker Nancy Pelosi (D-CA) released H.R. 3, the Lower Drug Costs Now Act, to make a series of changes to Medicare to lower the price of prescription drugs. The bill must move through three...more

Troutman Pepper

Bipartisan Senate Group Pushes Bill to Protect Patients from Surprise Medical Bills

Troutman Pepper on

In September 2018, we wrote about a draft U.S. Senate bill aimed to protect patients from surprise medical bills, the “Protecting Patients from Surprise Medical Bills Act.” ...more

Epstein Becker & Green

New Jersey’s Surprise Medical Bill Law: Part 1: Regulatory Issuances by New Jersey Agencies

Epstein Becker & Green on

Earlier this year, New Jersey Governor Phil Murphy signed into law the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (“Law”), creating a statutory framework attempting to protect...more

Buchalter

California Clamps Down On Surprise Out-Of-Network Bills

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On September 23, 2016, Governor Brown signed AB 72, California’s surprise out-of-network law. The bill protects patients who seek care at an in-network facility from balance billing by individual health care providers who are...more

Foley & Lardner LLP

California Targets Surprise Medical Bills, Follows on the Heels of New York and Florida

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Governor Brown approved a new law last Friday that limits patient exposure to so-called surprise medical bills. AB 72 caps the cost-sharing obligations of patients who unexpectedly receive care from non-contracted providers...more

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