The No Surprises Act, a component of the Consolidated Appropriations Act 2021, is a wide-ranging law that takes effect January 1, 2022.  The aims of the law are to reduce the occurrence of surprise bills (particularly, where insured patients unknowingly receive out-of-network services) and to require health insurers and health care providers to communicate with patients in advance of furnishing care about the anticipated costs of services. The law includes protections for privately insured patients and for self-pay/uninsured patients. Federal agencies issued regulations implementing the law this fall.

This webinar will cover the main provider-oriented requirements in the No Surprises Act that FQHC compliance professionals need to help their facility implement before the requirements go into effect on January 1, 2022. We will address the requirement in the law that providers and facilities provide to self-pay and uninsured patients a “good faith estimate” of the anticipated patient costs of services at the time a patient makes an appointment or requests the estimate, as well as the requirement (whose implementation has been postponed to a future date) to provide health plans with a similar good faith estimate regarding scheduled services for privately insured patients. We will offer guidance to health centers on strategies for furnishing the good faith estimates that are consistent with health centers’ existing policies on fees and discounts, and for addressing the administrative burdens on health centers of furnishing the up-front estimate. 

We will also more briefly address other requirements in the No Surprises Act that have limited application to health centers, such as the protections it provides against insured patients encountering surprise bills for out-of-network services received in an in-network hospital, outpatient hospital department, or ambulatory surgical facility.