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Nearly 1 in 5  hospital visits result in patients getting the unwelcome surprise of an unexpectedly large bill because doctors or other providers weren’t part of their insurer’s network. To protect consumers, Congress passed the bipartisan No Surprises Act last December. But doctors and hospital groups are trying to delay its Jan. 1 rollout over a […]

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Key hospital and doctors’ lobbies have asked a federal court to immediately block the Biden administration from moving forward with a controversial piece of its most recent surprise billing rule that they allege illegally limits what an arbitrator can consider when resolving a payment dispute. The American Hospital Association, American Medical Association and several other […]

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Health insurers and medical providers are sharply split over a Biden administration rule that lays out how they should resolve disputes over surprise bills. Hospitals and doctors say they will be hurt by the rule implementing legislation to crack down on surprise billing, but health insurers and employers say it will prevent health-care price inflation. […]

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Stakeholders squared off again over what factors independent dispute resolution panels should consider when they settle payment disputes, as they met this week’s deadline to comment on the administration’s latest, highly controversial regulation implementing the surprise billing law. The law bans balance billing in out-of-network emergency rooms and OON care done at an in-network facility […]

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The detente that allowed Congress to pass a law to curb surprise medical bills has disintegrated. A bipartisan group of 152 lawmakers have been assailing the Biden administration’s plan to regulate the law and medical providers, warning of grim consequences for underserved patients. For years, patients have faced these massive, unexpected bills when they get […]

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Lawmakers who crafted last year’s law addressing surprise billing are once again at odds over policy particulars after the Biden administration issued a rule to implement the law in a manner that some say revives a congressional dispute. Certain members on Capitol Hill and influential voices in the health care industry that spent millions trying […]

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The Biden administration released a rule Thursday that addresses one of the most fought-over provisions of a coming ban on surprise medical bills. The rule details how a new class of medical billing arbiters will decide the fair price for emergency medical care, one of the largest sources of surprise bills. The rule received a positive […]

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Hospitals reacted sharply toward a Biden administration regulation implementing legislation barring “surprise billing” of patients while health insurers and employers’ groups praised it for guarding against health-care price inflation. The rule is a “windfall for insurers,” Stacey Hughes, executive vice president of the American Hospital Association, said. “The rule unfairly favors insurers to the detriment […]

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The Biden administration on Thursday issued an interim final rule with comment period to further implement the No Surprises Act – a consumer protection law that helps curb the practice of surprise medical billing. The rule – which goes into effect Jan. 1 – builds on an interim final rule issued back in July that bans […]

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The hospital industry blasted HHS on Thursday over an interim final rule laying out the new independent dispute resolution process for the surprise billing law, which hospitals say ignores congressional intent and puts the thumb on the scale in favor of insurers. But insurers and other stakeholders applaud the administration’s direction, saying that by requiring […]

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