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MGMA Asks HHS to Delay No Surprises Act Implementation, Enforcement

Analysis  |  By Alexandra Wilson Pecci  
   September 07, 2021

It also says that group practices shouldn't be required to obtain information about out-of-network plans.

Although HHS has already delayed some No Surprises Act provisions, the Medical Group Management Association (MGMA) is asking that implementation and enforcement be fully delayed because of the ongoing COVID-19 pandemic.

It also says that group practices shouldn't be required to obtain information about out-of-network plans, instead arguing that the responsibility for that should fall to the plan that already has an existing relationship with the patient.

MGMA submitted comments on the interim final rule about requirements related to Surprise Billing Part I, which implements certain provisions of the No Surprises Act.

In its advocacy letter, MGMA:

  • Urges HHS "to delay the implementation and enforcement of the surprise medical billing requirements as practices are still on the frontlines providing care to patients during the COVID-19 pandemic."
  • Expresses "serious concerns regarding the arbitrary and overburdensome requirements for the notice and consent process and fears that it could disrupt clinical care and practice operations."
  • Calls on HHS to "not require group practices to obtain information about specific prior authorization and care management processes from out-of-network plans." Instead, it argues that "the responsibility should be on the plan that manages and implements the utilization management requirements and has an existing relationship with the patient."

The No Surprises Act goes into effect January 1, 2022 and protects patients from surprise medical bills and establishes an independent dispute resolution process for payers and providers.

HHS has already said that it would defer enforcement of the No Surprises Act requirement for providers and facilities to provide good faith estimates for insured patients.

However, the requirement to provide a good faith estimate for people who are uninsured (or don't plan or using their insurance for a service) still stands and HHS plans to issue regulations for doing so soon.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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