Health Law Scan

Pressure continues to mount on the US Department of Health and Human Services (HHS) to reconsider and revise its August 2022 final rule modifying the No Surprises Act independent dispute resolution (IDR) process. The rule is an attempt to revise the original IDR process, which “placed its thumb on the scale” for payors, according to the February 2022 federal district court decision in Texas Medical Association v. US Department of Health and Human Services.

A federal judge in Texas held on February 23 that the federal government’s interim final rule implementing the independent dispute resolution (IDR) process established by the No Surprises Act conflicted with the plain language of the statute and that the agencies improperly bypassed notice and comment rulemaking when promulgating the rule.

As its name suggests, the No Surprises Act establishes patient protection against most surprise medical bills from out-of-network, emergency service, and air ambulance providers. Two of the major provisions affecting providers—the good-faith estimate and balance billing requirements—became effective as of January 1, 2022.

Our labor and employment team recently published a LawFlash analyzing the US Departments of Treasury, Labor, and Health and Human Services and Office of Personnel Management’s Requirements Related to Surprise Billing; Part 1.