Please join us on Tuesday November 9th, 2021 at 1PM Eastern as Epstein Becker Green’s Helaine Fingold and Bob Hearn help stakeholders sort through the No Surprises Act with guidance on compliance and discussion of the issues, implications, and resulting opportunities, in the HealthcareWebSummit event: Making Sense of the No Surprises Act and Interim Final Rules.
Webinar: Tuesday, November 9, 2021, at 1:00 PM – 2:00 PM Eastern
- Key components of the No Surprises Act, and subsequent Interim Final Rules
- Specific and “operationalized” guidance on complying with the Act
- Interaction of the Act with state balance billing laws
- Impact and scope of the Act on billing for ancillary services provided outside of, but associated with, a hospital visit
- Business opportunities emerging from implementation of the Act
Faculty: Helaine I. Fingold, Member of the Firm, Epstein Becker Green, and Robert (Bob) R. Hearn, Member of the Firm, Epstein Becker Green
The No Surprises Act, included within the Consolidated Appropriations Act, a massive piece of COVID-19 relief legislation signed into law in late 2020, is set to become effective January 1, 2022. While the laudable goal of the Act is to protect patients from surprise billing, the law and its associated rules will also impose significant compliance burdens on health plans, providers, and facilities with regard to their patient billing and claims submission processes, as well as with respect to making novel patient and plan billing rights disclosures and meeting the Act’s unprecedented price transparency requirements. The requirements of the No Surprises Act are complicated by their complex interaction with an inconsistent and confusing patchwork of state laws and administrative rules on the same subject.
With two Interim Final Rules and one Proposed Rule issued for the No Surprises Act, there is now detailed information available for health plans and providers to digest in order to best prepare for January 1, 2022 compliance with the law. In July 2021, the Administration released the Interim Final Rule for the No Surprises Act: “Requirements Related to Surprise Billing; Part I, addressing:
- Definitions critical to the Act’s application, including what constitutes emergency and post-stabilization care;
- The specifics of the billing prohibitions applicable to providers and facilities;
- The Act’s application to ancillary service providers;
- Billing rights disclosures; and
- The mechanics of the Act’s various notice and consent processes;
The Interim Final Rule for the No Surprises Act: “Requirements Related to Surprise Billing; Part II,” was issued at the send of September 2021, and includes the following provisions:
- A process that takes consumers out of the middle of a payment dispute between out-of-network providers and health plans;
- Requirements for providing health care cost estimates to uninsured (or self-pay, meaning you have coverage but choose not to have your care billed to your health plan) individuals;
- A payment dispute resolution process for uninsured (or self-pay) individuals; and
- Expanded rights to external review (what individuals with job-based or individual health plans can use to dispute when certain claims are denied payment, as described below).
Earlier in September, the Administration released a Proposed Rule addressing data reporting requirements on the air ambulance provider industry and other disclosure and enforcement provisions.
With the January 1, 2022, implementation deadline approaching rapidly, health plans, health care facilities, providers, and ancillary service entities that support hospital in-patient, out-patient, and emergency operations are scrambling to figure out what the new federal law and its implementing rules means for them.
In this session, Epstein Becker Green’s Helaine Fingold and Bob Hearn help to make sense of the Act, examine the business opportunities and solutions that exist despite the high-stakes legal, policy, and regulatory issues that the health care industry faces, and discuss specific and “operationalized” guidance to providers, facilities, and health plans on complying with the Act, including its challenging interaction with state balance billing laws. Their insights are based on experience in this arena and are rededicated to deciphering the complex interaction between state law and the new federal law.
- Individual Registration: $195
- Individual Registration and Post-event materials - Includes webinar video and presentation pdf file: $240 for attendees
- Post-event materials for non-attendees - Includes webinar video and presentation pdf file. Available after the event: $260
MCOL Premium members receive a 50% discount on all Healthcare Web Summit events. Members can get the discount code by logging onto the Premium Member Website and then going to the Premium Member HealthWebsummit page. Non-members can learn about MCOL Premium memberships and sign-up to get the 50% discount on this and future events.
Need a Printable Form? Download a registration form you can fax or mail.
In addition to the main presentation, this webinar will include an opening introductory video, a brief moderated speaker interview, and audience Q&A. Within one business day of your registration, you'll receive login information. You will receive a reminder email 1 day and 1 hour before the live event.
One day after the live webinar, you'll receive a follow-up email which will include a link to the presentation slides. You’re also welcome to provide feedback via this email as well as submit additional questions to be forwarded to the speakers. For support before, during or after the event, please contact HealthcareWebSummit office at 209.577.4888.
After attending this webinar, attendees will be able to:
- Understand the key components of the No Surprises Act, and subsequent Interim Final Rules
- Possess specific and “operationalized” guidance on complying with the Act
- Ascertain the challenging interaction of the Act with state balance billing laws
- Consider the impact and scope of the Act on billing for ancillary services provided outside of, but associated with, a hospital visit
- Examine the business opportunities emerging from implementation of the Act
- Benefit from interactive learning including opportunities to engage with faculty with questions and discussion
Interested attendees would include:
- C-Suite Executives
- Legal and Regulatory Executives and Staff
- Compliance Officers and Staff
- Policy, Planning and Strategy Executives and Staff
- Provider Network Executives and Staff
- Provider Contracting Executives and Staff
- Provider Data Governance Managers
- Revenue Cycle Management Executives and Staff
- Business Intelligence Staff
- Health Benefit Managers and Staff
- Benefit Consultants
- Operations Executives and Staff
- Other Interested Parties
Attendees would represent organizations including:
- Health Plans
- Hospitals and Health Systems
- Provider Networks
- Accountable Care Organizations
- Clinically Integrated Networks
- Medical Groups
- Benefit Consulting Organizations
- Third Party Administrators
- Solutions Providers
- Associations, Institutes and Research Organizations
- Government Agencies
- Other Interested Organizations
Helaine I. Fingold
When clients need help understanding the federal and state regulation of health insurance, and identifying and addressing related barriers and opportunities, they turn to Helaine Fingold. Clients benefit from Helaine’s experience working at both the Centers for Medicare & Medicaid Services and the Medicare Payment Advisory Commission (MedPAC), which has given her keen insight into how regulators interpret and apply the laws, regulations, and related administrative processes regarding Medicare, Medicaid, and commercial insurance.
Her clients range from small start-ups to large corporate entities with multiple subsidiaries. They include Medicare Advantage, PACE, Medicaid, and other managed care plans; provider entities; vendors to providers and managed care companies (including administrative support entities, providers of software and online services, agents/brokers/field marketing organizations, and advertising/marketing entities).
Helaine’s practice focuses largely on the regulation of Medicare managed care (including Medicare Advantage, Part D, dual eligibles, PACE, demonstrations), Medicaid managed care, commercial managed care products (including surprise billing), and behavioral health (including mental health parity).
Robert (Bob) R. Hearn
Bob Hearn believes in making legal work count and never losing sight of every task’s value proposition. He uses creative but practical strategies to resolve disputes, manage liabilities, and untangle regulatory and compliance challenges in an efficient yet durable manner. That’s why clients trust him when complex and potentially costly matters require attention.
Bob’s practice, while legally diverse—covering both litigation and regulatory, compliance, and business counseling work—focuses almost exclusive on the health care and life science sector. Bob has dedicated a significant part of his career to representing a national clinical laboratory in a wide array of litigation matters and in facility and personnel licensure and certification, billing, compliance, regulatory, and payor-oriented matters that span the lab’s operations.
In addition to his deep experience with laboratories, Bob serves a broad range of health care and life sciences clients. Clinical research entities, pharmaceutical companies, medical product manufacturers, medical practices, and other health service providers also turn to Bob to defend them in products liability, death and injury, and commercial litigation and to advise them on risk mitigation and regulatory and compliance concerns.