Compliance Alert: CMS Publishes New No Surprises Act “Consumer-Friendly” Resources Webpage


Providers should be aware consumers now have access to CMS resources that help them understand their rights under the No Surprises Act (NSA). In general, the NSA protects healthcare consumers from receiving surprise medical bills following most emergency services, some non-emergency services, and services from an out-of-network air ambulance. There are three primary obligations under the NSA: (1) the “balanced billing” prohibitions, (2) the “good faith estimate” obligations, and (3) the public disclosure requirements. Providers performing services in hospitals and ambulatory surgical centers must implement policies and procedures to ensure compliance with the balanced billing prohibition and the public disclosure requirements. All providers and facilities could be subject to the good faith estimate obligations. As a result of CMS’ new webpage, there may be an increase in payment disputes under the “patient-provider dispute resolution” as well as complaints submitted to the CMS “No Surprises Help Desk”. If a bill is disputed or an investigation is launched as a result of a complaint, evidence of compliance through appropriate policies and procedures is essential. The new consumer-friendly webpage can be found here. CMS’ webpage for provider NSA resources can be found here.

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