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The Saga of the No Surprises Act Continues to be … Surprising

We previously noted that the regulations implementing the No Surprises Act (“NSA”) appeared to be inconsistent with the NSA because they seemed to establish the qualifying payment amount (“QPA”) as the appropriate payment...more

No Surprises Act’s Regulation Establishing QPA as Presumptive Payment Amount Vacated by District Court

We previously noted that the No Surprises Act (NSA) regulation’s establishment of the presumption that the qualifying payment amount (QPA)—generally, the median payment by the plan to providers in the region—is the...more

The Devil may be in the Details of the Part II No Surprises Act IFR

This post reviews Part II of the federal No Surprises Act regulations.  In previous publications, we have commented upon the No Surprises Act, and Part I of the regulations. The “Requirements Related to Surprise Billing;...more

The Surprises Continue: The Biden Administration Delays Implementation of Certain Provisions of the No Surprises Act and...

In a FAQ published on August 20, 2021, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) significantly delayed implementation of statutory requirements on surprise billing...more

No Surprises Act Regulations – Insurer Requirements

This post provides an update to our previous publication summarizing the federal No Surprises Act and is part two of two in a series on new interim regulations implementing certain requirements of the No Surprises Act. In...more

No Surprises in Initial No Surprises Act Regulations

This post provides an update to our previous publication summarizing the federal No Surprises Act and is part one of two in a series on new interim regulations implementing certain requirements of the No Surprises Act....more

New Federal Transparency Requirements Impacting Health Providers and Plans

As promised, this is a follow-up to our first blog post on the new federal transparency requirements. In our prior post, we summarized the Hospital Price Transparency rule which went into effect on January 1, 2021, and here...more

Supreme Court Hears Oral Argument in King v. Burwell: Will Impermissible Federal Coercion Save the ACA?

Yesterday, the Supreme Court heard oral argument in King v. Burwell, which some describe as an argument over a mere four words – "established by the state." But to the surprise of many, the Justices did not spend most of the...more

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