Podcast: No Surprises Act: New Rules and Guidance for Stakeholders (Part 2) - Diagnosing Health Care
The SDNY U.S. Attorney’s Office has targeted several labs and their principals for False Claims Act violations arising out of reimbursements for COVID-19 testing services. In a complaint filed on June 13, the government sued...more
Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more
The Families First Coronavirus Response Act (FFCRA) was enacted in March 2020 as part of the government’s response to the COVID-19 pandemic. The FFCRA, among other things, provided funds for diagnostic testing and services...more
Starting in mid-2024, Illinois hospitals will be required to take a much more active role in limiting consumers’ medical debt by screening all consenting uninsured patients for both public health insurance program coverage...more
Are you a health care provider who received funds from the Health Resources and Services Administration's ("HRSA' s") COVID-19 Uninsured Program? If so, more inquiries and repayment demands may be coming....more
On Friday, December 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued an FAQ regarding the Good Faith Estimate (GFE) and Convening Provider/Facility requirements in the Federal No Surprises Act. The issued...more
Since January 1, 2022, the No Surprise Billing Rules (NSBR) have required virtually all healthcare providers to give a good faith estimate of anticipated charges to uninsured (self-pay) patients.1 Unless the Department of...more
CMS continued to roll out guidance regarding the No Surprises Act. The latest guidance is the second set of FAQs regarding the Good Faith Estimate Requirement for uninsured and self-pay patients was issued on April 5, 2022....more
Providers who rely on the Health Resources & Services Administration (“HRSA “) COVID-19 Uninsured Program (“UIP”) for reimbursements related to COVID-19 testing, treatment, and vaccine administration will no longer be...more
On March 15, 2022, the Health Resources & Services Administration (HRSA) announced that the Uninsured Program will stop accepting claims for COVID-19 testing and treatment on March 22, 2022 at 11:59 PM ET due to lack of...more
The Biden administration has released a series of rules and guidance to implement the No Surprises Act, which went into effect on January 1. All providers and facilities must now provide a good faith estimate to uninsured and...more
The No Surprise Billing Rules took effect January 1, 2022, but many questions remain, including if and to what extent the new rules for good faith estimates apply to items or services that are provided to self-pay patients on...more
The federal No Surprises Act went into effect on January 1, 2022. The Act is aimed at reducing “surprise bills” to patients in the context of services provided at hospitals and ambulatory surgical centers, and includes...more
Beginning January 1, 2022, all state licensed or certified health care facilities and providers must follow extensive rules for providing a "good faith estimate" of health care charges to uninsured and self-pay patients prior...more
As health care organizations are generally aware, most regulatory requirements related to the federal No Surprises Act apply beginning January 1, 2022. These surprise billing regulations implement a number of new patient...more
The Centers for Medicare & Medicaid Services (CMS) recently released template documents and model notices to help healthcare providers comply with the No Surprises Act, which was passed as part of the Consolidated...more
On November 13, 2020, the D.C. Court of Appeals upheld a key ruling regarding disproportionate share hospital (“DSH”) payments, in Bethesda Health Inc. v. Azar, a significant victory for hospitals. Hospitals that treat a...more
In an unprecedented move touted as necessary to address the COVID-19 testing shortage, the U.S. Department of Health and Human Services (HHS) made a brief statement on August 19 that effectively rescinded the federal Food and...more
As COVID-19 testing continues to increase throughout the nation, providers and patients alike are faced with the issue of who is responsible for covering the cost of testing. Whether a payor will reimburse for a COVID-19 test...more
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), launched a COVID-19 Uninsured Program Portal. The new portal allows healthcare providers who have...more
HHS has published additional Terms and Conditions associated with the acceptance of payments made from the $100 Billion Provider Relief Fund established pursuant to the Coronavirus Aid, Relief, and Economics Security Act...more
In recent days, the federal government has taken two significant steps to increase healthcare funding to assist providers in responding to the medical and economic consequences of the novel coronavirus pandemic. $100 Billion...more
On April 27, 2020, the Department of Health and Human Services ("HHS") launched the COVID-19 Uninsured Program Portal, allowing health care providers who have conducted COVID-19 testing or provided treatment for Uninsured...more
On April 3, 2020, President Trump and Alex Azar, Secretary of the Department of Health and Human Services (HHS) announced that the federal government would reimburse healthcare providers who treat uninsured patients suffering...more
King & Spalding’s Healthcare Finance practice is working to keep clients informed of issues that may be of concern to lenders in the healthcare space. Providers are continuing to face financial difficulties due to spikes in...more