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AMA, AHA, CMS Add No Surprises Act Resources

Analysis  |  By Alexandra Wilson Pecci  
   January 17, 2022

Advisories, information sheets, and FAQs aim to help hospitals, health systems, physicians, and consumers understand the new rules against surprise billing.

Despite ongoing legal challenges to parts of the No Surprises Act, key elements of it went into effect on January 1, and stakeholder organizations are responding with guidance for their constituents. In addition, CMS has added new information on its website for consumers.

Here's some of the latest:

The American Hospital Association on Friday published a No Surprises Act legislative advisory that includes a summary of and key takeaways about the law, along with a 15-page detailed summary of the rules.

"The hospital and health system field strongly supports protecting patients from surprise medical bills," the American Hospital Association said in a statement. "We believe this legislation is an important step forward in protecting patients."

In addition, the legislative advisory webpage links to additional resources, including an FAQ for members about the uninsured/self-pay good faith estimate; details about the AHA/AMA lawsuit challenging how federal regulators proposed resolving billing disputes; and information about CMS guidance.

The American Medical Association on Friday published an advocacy update outlining what physicians need to know about the No Surprises Act.

It links to a newly published toolkit that focuses on three key issues for physicians to know about and understand: the notice-and-consent requirements for when out-of-network clinicians provide care at in-network facilities; rules about emergency services and post-stabilization care at hospitals or freestanding emergency departments; and the requirement to provide good faith estimates for self-pay and uninsured patients. 

An AMA Advocacy Insights webinar on Jan. 20 will dive further into the topic.

Also on Friday, CMS added online information for consumers explaining that as of January 1, "consumers have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers."

"Through new rules aimed to protect consumers, excessive out-of-pocket costs are restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network," the website says.

The new page also links to explanatory resources for consumers, including ones that outline what surprise bills are and the new consumer protections that are now in place thanks to the No Surprises Act.

Other No Surprises Act resources for hospitals and health systems to know about are available from the Healthcare Financial Management Association and the Medical Group Management Association.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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