Read on Twitter
I finally had a chance to read the legislative summary of the No Surprises Act. And I think it's ok-"ish." https://twitter.com/ACEPNow/status/1338864655620403201
Sec.102: 'Requires that out-of-network surprise bills are attributed to a patient’s in-network deductible.'
Good. When a patient gets care from a doc, it counts towards the deductible either way. Not different INN and OON deductibles.
Good. When a patient gets care from a doc, it counts towards the deductible either way. Not different INN and OON deductibles.
Sec.103:
Batching. Great.
IDR tied to median-in-network rate. No super happy about it because it's one sided in favor of insurance companies as @TheRevAl says. https://twitter.com/TheRevAl/status/1337524161128886272
90 day cooling off period. That's just dumb. One a dispute is resolved via IDR, let it stand.
Batching. Great.
IDR tied to median-in-network rate. No super happy about it because it's one sided in favor of insurance companies as @TheRevAl says. https://twitter.com/TheRevAl/status/1337524161128886272
90 day cooling off period. That's just dumb. One a dispute is resolved via IDR, let it stand.
Sec.115:
All-payer claims databases!
All-payer claims databases!
Sec.117:
"If a patient receives a bill more than 90 calendar days after receiving care, the patient is not obligated to pay."
Who isn't cool with that?
"If a patient receives a bill more than 90 calendar days after receiving care, the patient is not obligated to pay."
Who isn't cool with that?
There are a couple fixes that need to be made to improve this bill.
1. If you are going to mandate median in-network rate be considered by an arbiter, then you need to mandate median-charge to be considered.
1. If you are going to mandate median in-network rate be considered by an arbiter, then you need to mandate median-charge to be considered.
2. Once an arbitrator decides the price of a specific CPT code between a doctor & an insurance company, that should stand for 365 days, not re-litigating it 90 days later after a cooling off period.
Fix those 2 issues and I'm
% in.
Fix those 2 issues and I'm
% in.
