On February 17, 2022, the Department of Insurance (the “department”) issued Bulletin No. 3-2022 regarding the federal No Surprises Act (NSA). The purpose of the bulletin was to provide information on NSA requirements that apply to healthcare providers and facilities and air ambulance services, effective in 2022.
The bulletin outlines the NSA prohibitions against balance billing of consumers for covered items and services, including out-of-network (OON) emergency and air ambulance services and certain non-emergency OON services received at in-network facilities. Additionally, the bulletin summarizes related NSA obligations regarding disclosures and the maintenance of updated provider directories. The guidance also reviews the available methods, including the use of an independent dispute resolution process, to resolve disputed OON bills between providers and group health plans or insurers.
Enforcement of the NSA provisions depends on the circumstances and may come from one of the several federal and state regulatory agencies, including the department. According to the bulletin, the department’s enforcement role includes receiving complaints from consumers on NSA issues and referring these complaints to federal agencies, as appropriate.
Although the guidance is primarily directed to insurers and providers, employers who sponsor group health plans may want to be aware of this bulletin.
Bulletin No. 3-2022 - No Surprises Act (NSA) »
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