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Key shock billing ban particulars nonetheless murky

With 5 months earlier than the shock billing ban takes impact, the Biden administration hasn’t launched a lot of crucial particulars about how the No Surprises Act will work, leaving suppliers and insurers little time to plan for the adjustments.

CMS’ first rule outlawing stability billing contained anticipated affected person protections in opposition to shock billing and excessive cost-sharing for out-of-network care, as outlined within the December legislation.

However suppliers and insurers are nonetheless at midnight concerning the unbiased dispute decision course of and the way regulators will outline key phrases for arbitrators or calculate median in-network charges.

“It is not likely what suppliers or payers have been searching for,” Avalere Well being guide Tim Epple mentioned. “I do not suppose there may be something that we have seen that differed meaningfully from the legislative textual content or the intent of the statute.”

Healthcare executives may begin to get antsy

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