On August 2,2024, the Fifth Circuit affirmed the vacatur of federal rulemaking related to the No Surprises Act’s (NSA) Independent Dispute Resolution (IDR) process. The Court held that the No Surprises Act does not permit the...more
8/15/2024
/ Article III ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Final Rules ,
New Regulations ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Payment Systems ,
Vacated
On March 18, 2024, thirty-nine (39) members of the United States House of Representatives sent a letter urging federal agencies to finalizing rulemaking regarding the implementation of the No Surprises Act. The letter,...more
On October 27, 2023, the Departments of HHS, Labor, and Treasury and the Office of Personnel Management (the Departments) released a proposed rule updating the payor-provider dispute resolution process under the federal No...more
Last week, a number of developments arose stemming from the various lawsuits challenging the No Surprises Act. First, in response to the Eastern District of Texas’ order vacating the administrative fee guidance for the...more
On July 6, 2023, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released the first of five required annual reports on the impact of the No Surprises Act (NSA) on health care markets (the Report)....more
7/21/2023
/ Billing ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Out-of-Pocket Expenses ,
Surprise Medical Bills
On May 10, 2023, HHS announced that many telehealth and teleprescribing flexibilities will remain in place after the end of the COVID-19 Public Health Emergency (PHE) on May 11, 2023. Congress extended many telehealth...more
5/22/2023
/ ACOs ,
Children's Health Insurance Program (CHIP) ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
DEA ,
Department of Health and Human Services (HHS) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medicare Advantage Organizations (MAOs) ,
OCR ,
Opioid ,
Public Health Emergency ,
SAMHSA ,
Telehealth
On August 19, 2022, the Departments of Health and Human Services, Labor, and the Treasury (the Departments) issued a long-awaited final rule (the Final Rule) on the Independent Dispute Resolution (IDR) Process under the No...more
On July 26, 2022, LifeNet was granted summary judgment in its challenge to portions of the second set of implementing regulations for the Independent Dispute Resolution (IDR) process for air ambulance providers under the No...more
8/4/2022
/ Administrative Procedure Act ,
Appeals ,
Arbitration ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
OMB ,
Out of Network Provider ,
Summary Judgment ,
Surprise Medical Bills ,
Texas ,
Vacated
On February 23, 2022, the Texas Medical Association was granted summary judgment in its challenge to portions of the second set of implementing regulations that implement the No Surprises Act’s Independent Dispute Resolution...more
Last week, HHS announced the distribution of more than $2 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments. These payments bring the Phase 4 distribution total to approximately $11 billion of the...more
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
12/23/2021
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Disclosure Requirements ,
Employee Retirement Income Security Act (ERISA) ,
Health Care Providers ,
Medicaid ,
Medicare ,
Medicare Advantage ,
No Surprises Act (NSA) ,
Reimbursements ,
Surprise Medical Bills
On November 5, 2021, 152 members of the U.S. House of Representatives submitted a letter to the Secretaries of the Departments of Health and Human Services, Labor, and the Treasury (the Departments) urging the Departments to...more
On March 16, 2021, a federal judge issued a preliminary injunction blocking HHS from implementing the 340B administrative dispute resolution final rule (the Final Rule) released in December 2020. The blocked Final Rule would...more
On December 30, 2020, the HHS Office of General Counsel (OGC) issued Advisory Opinion No. 20-06 finding the 340B Federal Drug Pricing Program requires drug manufacturers to extend 340B pricing to covered outpatient drugs...more