Legal Challenges to the No Surprises Act and What is at Stake

June 8, 2022  |  By: Medcom
Professional Development  |  Running Your Business  |  No Surprises Act

The No Surprises Act has, amongst other things, prohibited out-of-network providers from balance billing patients in an emergency and other limited situations, and has placed the burden on health plans and providers to negotiate agreeable rates. However, when this fails, the providers and health plans must go to a certified arbitrator approved by the Centers for Medicare and Medicaid Services. The arbitrator will review each of the proposed amounts and choose one. It sounds simple, but wait, there have been court challenges.

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