No Surprises Act Guidance for Health Plans: Final Rules, IDR Process, Qualifying Payment Amounts, Disclosures
Recording of a 90-minute premium CLE video webinar with Q&A
This CLE webinar will provide employee benefits counsel, plan sponsors, and administrators guidance on key provisions and requirements of the final rules implementing the No Surprises Act (NSA). The panel will discuss the good faith estimate requirements for uninsured or self-pay patients, surprise billing prohibitions, notice and consent requirements, and the payment process under the Act. The panel will also provide a deep dive into the qualifying payment amount (QPA), and independent dispute resolution (IDR) processes under the final rules.
Outline
- Overview and background of the NSA
- Surprise billing prohibitions
- Notice and consent
- Enforcement
- Final rule implementing the NSA
- QPA disclosure requirements
- Federal IDR process
- Best practices to ensure compliance
Benefits
The panel will discuss these and other key issues:
- What are the regulatory requirements under Part I and Part II of the Interim Final Rule?
- What are the challenges with surprise billing prohibitions, notices, and disclosures for plan sponsors and administrators?
- What are the critical components of the recently issued final rule under the NSA?
- What are the QPA disclosure requirements?
- How do you navigate the federal IDR process?
Faculty
Laura Miller Andrew
Counsel
Smith Gambrell & Russell
Ms. Andrew advises clients in all major aspects of employee benefits including qualified and nonqualified plans, IRS... | Read More
Ms. Andrew advises clients in all major aspects of employee benefits including qualified and nonqualified plans, IRS and DOL compliance matters, merger and acquisition issues, executive compensation, and employment agreements. She also concentrates her practice in health care related matters, including health care reform legislation, compliance with HIPAA, federal and state health care anti-fraud laws, such as anti-kickback statute, and Stark Law. Ms. Andrew also advises nursing homes, assisted living facilities, medical device, and life sciences organizations regarding compliance with state and federal regulatory requirements.
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Milanna Datlow
Attorney
Robinson & Cole
Ms. Datlow is a member of the Managed Care + Employee Benefit Litigation Group. She has experience defending group... | Read More
Ms. Datlow is a member of the Managed Care + Employee Benefit Litigation Group. She has experience defending group welfare benefits and pension benefits plans subject to the Employee Retirement Income Security Act (ERISA) against allegations of fiduciary violations and other claims under ERISA brought by the Secretary of Labor and by a workers' union in an alleged class action. Ms. Datlow also defended cases involving allegations of medical malpractice as well as hospital negligence. Recently, she obtained a dismissal of a vicarious liability claim against a national operator of hospitals by successfully showing that the expert opinion letter accompanying the complaint did not meet the statutory mandate. Additionally, Ms. Datlow has experience defending discovery of peer review material and doctors' credentialing files, and has written on the topic of hospital risk management.
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Virginia B. Flynn
Partner
Troutman Pepper Hamilton Sanders
Ms. Flynn is a partner in the firm’s Consumer Financial Services practice and specifically within... | Read More
Ms. Flynn is a partner in the firm’s Consumer Financial Services practice and specifically within the Financial Services Litigation practice. She represents clients in federal and state court, both at the trial and appellate level in the areas of complex litigation and business disputes, health care litigation, including ERISA and out-of-network issues, and consumer litigation in more than 21 states nationwide. As a result of new legal developments, Ms. Flynn increasingly counsels clients to ensure they comply with the myriad of growing laws in the consumer law with a particular emphasis on the intersection of TCPA and HIPAA.
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