News & Analysis as of

Regulatory Requirements Health Care Providers Out of Network Provider

Cozen O'Connor

NY AG Puts Mental Health Ghost Network to Rest

Cozen O'Connor on

New York AG Letitia James has announced an agreement with MVP Health Plan (MVP) following an investigation that found systemic problems with the insurer’s mental health provider network. The investigation revealed that MVP’s...more

Ballard Spahr LLP

Surprise, Surprise! No Surprise Billing Regulations Upheld

Ballard Spahr LLP on

The Fifth Circuit Court of Appeals recently upheld regulations defining the qualifying payment amount (QPA). The QPA is a key factor in determining how much individuals and health plans must pay out-of-network providers in...more

Polsinelli

Federal Court Strikes Additional Portions of Regulations Implementing No Surprises Act Addressing Air Ambulance Services

Polsinelli on

Five months ago, in TMA v. HHS, et al. (“TMA”), a federal court in Texas struck down portions of a controversial interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) intended to...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

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