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HHS Extends Deadline for Co-Provider Requirements Under the No Surprise Billing Rules
/in No Surprise BillingBy Kim Stanger
As discussed in our November 28 client alert, the No Surprise Billing Rules (NSBR) require that convening providers contact co-providers and include co-provider fees in the convening provider’s good faith estimate to uninsured (self-pay) patients. Read more
Gifts to Patients and Referring Providers
/in ProvidersBy Kim Stanger
At this time of year, healthcare providers may want to give gifts to patients, referring providers, or other sources of business, but such gifts may violate federal and state fraud and abuse laws and result in civil or criminal fines for both the giver and receiver. Read more
Prepare for the End of the Public Health Emergency: Compliance Concerns
/in Compliance, COVID-19By Kim Stanger
For nearly three years, federal and state agencies have waived or relaxed regulatory requirements and expanded reimbursement for services due to the COVID-19 public health emergency (PHE), but the signs indicate that the party is nearly over. Many states have already ended their emergency exceptions, and the federal PHE appears to be coming to an end. The current 90-day PHE extension issued by the Health and Human Services (HHS) will expire January 11, 2023. (See here.) The Biden Administration has informally promised that it would notify stakeholders at least 60 days in advance of ending the PHE; consequently, there is a good chance that the PHE will be extended an additional 90 days into April 2023, but no formal announcement has issued yet. In the meantime, HHS has warned providers that most of the PHE waivers will end upon termination of the PHE and that providers should prepare now for a return to normal standards. (See CMS, “Creating a Roadmap for the End of the COVID-19 Public Health Emergency” (8/18/22), available here.) Read more
No Surprise Billing Rules: Co-Provider Requirements Begin in 2023
/in No Surprise BillingBy Kim Stanger
Update: On December 2, 2022, HHS issued new guidance extending the January 1, 2023 compliance deadline for co-provider requirements until further rulemaking. For more information, click here. The new guidance affects the remaining content below.
Since January 1, 2022, the No Surprise Billing Rules (NSBR) have required virtually all healthcare providers to give a good faith estimate of anticipated charges to uninsured (self-pay) patients.1 Unless the Department of Health and Human Services (HHS) changes its rules, beginning January 1, 2023, the good faith estimate provided to patients will need to include the anticipated charges from co-providers or co-facilities in addition to the convening provider’s own charges. Read more
Idaho Patient Act: Flow Chart
/in Idaho Healthcare LawBy Kim Stanger
Idaho healthcare facilities and providers may struggle to understand or stay on top of the requirements of the Idaho Patient Act (“IPA”), which limits providers’ ability to pursue collection actions unless certain conditions are satisfied. To learn more about the IPA (including recent changes), see our article here.
In addition, we provide the attached Flow Chart summarizing the relevant requirements and timelines for IPA compliance. We hope that it will help our clients and friends navigate the IPA rules more easily.