Hospital group gives 3 suggestions for No Surprises Act's implementation

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The Federation of American Hospitals sent a letter to President Joe Biden's Cabinet secretaries suggesting how to execute the No Surprises Act, slated to take effect on Jan. 1, 2022.

The No Surprises Act, a measure to end surprise medical bills for emergency and scheduled care, was passed in December when then-President Donald Trump signed a $1.4 trillion year-end spending bill into law. 

Below are three key suggestions the Federation of American Hospitals included in its letter, sent June 15:

  1. Healthcare providers and insurers must be afforded enough time to provide input and prepare for the new billing practices that will come into effect.

  2. Qualifying payment amounts should be set using statistics specific to the geographical area, and only comparable rates should be included as inputs for qualifying payment amount calculation. These calculations should include total maximum payments between a health plan and its in-network providers, an add-on percentage to offset in-network services' discounts, facility type and patient acuity.

  3. A patient's treating provider should be the one who determines if they are stable and able to give consent to receive out-of-network care, and payers should not weigh in on this matter. 

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