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ACP advocates on behalf of internal medicine physicians and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
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The No Surprises Act (NSA) prohibits balance billing insured patients who receive emergency or non-emergency services from out-of-network providers at in-network facilities for amounts greater than the patient’s in-network cost-sharing requirement for such services. The NSA also establishes a payment dispute resolution process and requirements to provide good faith estimates to uninsured or self-pay patients. (Note: This rule applies to private pay patients because Medicare and Medicaid already have protections against surprise billing.)
- This CMS page includes fact sheets, summaries, and resources for and . Below we highlight some key guidance related to dispute resolution:
- This toolkit can help practices understand and comply with the No Surprises Act, including responsibilities for preparing Good Faith Estimates for self-pay and uninsured patients.
Health plans also have obligations under this rule, particularly with respect to keeping provider directories current. CAQH offers a 2-page of those requirements.
The Consumer Financial Protection Bureau debt collectors and credit bureaus not to collect on medical bills protected under the No Surprises Act.
- CMS has published letters to help determine which surprise billing requirements are enforceable by each state or territory and which requirements CMS will enforce.