The Departments of Health and Human Services, Labor, and Treasury recently issued the first of two Interim Final Regulations (IFR) to implement the new “surprise billing” rules that will take effect for plan years beginning on or after January 1, 2022. The “No Surprises Act,” which will affect group health plans and participants, as well as health insurers and health care providers, was passed as part of the Consolidated Appropriations Act (CAA), 2021.
Briefly, the new restrictions on “surprise billing” will apply to certain emergency services provided by out-of-network providers and/or at out-of-network facilities, certain non-emergency services provided by out-of-network providers at participating facilities, and out-of-network air ambulance services. However, participants can waive the surprise billing protections in certain limited circumstances in which they otherwise would apply.
IFR Part 1 highlights include:
To read a comprehensive summary of “Surprise Billing” IFR Part 1, please download the accompanying PDF file, prepared by the law offices of Davis & Harman LLP.
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