Bass, Berry & Sims attorney Jeff Davis highlighted challenges related to the No Surprises Act’s requirements for healthcare provider organizations to furnish good faith estimates of expected charges. The government has yet to implement a requirement for providers to share good faith estimates with commercial payers, which must be provided in turn to patients as part of an advanced explanation of benefits (AEOB). Provider organizations and payers need to create a more robust interoperability to provide those estimates to patients, and to do that, they need more time. As Jeff said in the article published by the Healthcare Financial Management Association (HFMA), “There’s a hope—if not an expectation—that there will still be some more time to come before they have to comply with those requirements.”
After the article was published in print, the U.S. Departments of Health and Human Services, Labor and Treasury issued a request for information on how to implement the AEOB requirement, with comments due from industry stakeholders by November 15.
Providers are also experiencing challenges related to the provision of good faith estimates to uninsured and self-pay patients and the inclusion of cost estimates from co-providers. As Jeff noted, “There’s a technology issue in terms of flow of data, but also the facility is relying on co-providers to share information with them, and that’s out of their control.”
Jeff provided these insights on implementation of the No Surprises Act for HFMA’s article, “No Surprises Act Regulations Remain a Moving Target for Compliance,” published in the October issue of its monthly magazine, hfm, and also available online (free registration may be required).