CMS Releases Second Interim Final Rule on Surprise Billing
On September 30, 2021, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (IFR) to address large out-of-pocket costs to consumers from “surprise billing.” This IFR is the second set of rulemaking from the current Administration that implements the No Surprises Act, signed into law December 2020. The overall intent of the No Surprises Act is to protect consumers against surprise medical billing when there is a dispute between providers and payers regarding out-of-network (OON) rates.
This second IFR outlines the federal independent dispute resolution process, good faith estimate requirements for uninsured (or self-pay) individuals, patient-provider dispute resolution processes for uninsured (or self-pay) individuals, and external review provisions of the No Surprises Act. This ruling, expected to take effect on January 1, 2022, will ban surprise billing for emergency services and some non-emergency services by limiting the high OON cost-sharing. Comments on the IFR can be made no later than December 6, 2021.
Prior rulemaking related to this includes “Requirements Related to Surprise Billing Part One interim final rule” which was released on July 1, 2021 and its provisions can be reviewed here.
The most recent requirements related to surprise billing can be reviewed here.
