Federal Surprise Billing Laws – A Status Update
Event Details
Join MHA on August 5, when representatives from the American Hospital Association will present details on implementing the federal surprise billing regulations. MHA’s partner law firm, Foley & Lardner, will also join us to discuss what is required under Massachusetts law and how the two laws intersect.
Out-of-network billing is being addressed by new federal and state laws that go into effect on January 1, 2022. In states that have existing surprise billing laws, the state law takes precedence, However, the laws have different — and sometimes conflicting — requirements.
While both laws contain provisions that will require extensive notice and disclosure to patients, increased transparency, and prohibitions on charging patients more than what they would owe for in-network services in emergency and some non-emergency situations, the federal law creates a process for determining a “qualifying payment amount” and allows for independent dispute resolution. In contrast, Massachusetts law tasks the Executive Office of Health and Human Services with making recommendations around developing default rates and has no provisions for arbitration.
