Where we’re going

Intensifying federal government oversight on the issue of healthcare price transparency and involvement in the resolution of provider and insurer payment disputes suggests a growing need to arm group health plan sponsors and participants with the information they need to navigate the No Surprises Act Independent Dispute Resolution (IDR) process. While enforcement of the evolving … Continued

Click here to access our latest article published in Employee Benefit Plan Review, a leading resource for benefit decision-makers, providing industry news, market trends and peer-inspired insights about improving outcomes, enhancing the patient experience and lowering the cost of care. Author Jack Towarnicky, member of aequum, was appointed in 2023 to a three year term … Continued

The No Surprises Act (the “NSA”) has generated (and will continue to generate) a significant amount of litigation. The Plaintiffs, who are primarily medical provider organizations, used the practice of forum shopping to bring their cases in the court that will treat them most favorably. For the rule-making cases, the most favorable is the United … Continued

A growing movement is afoot to help Americans erase medical debt. It’s part of a cultural tipping point that acknowledges the financial fragility of both working and middle-class households. Many who secure treatment are unable to pay their out-of-pocket expenses – households living paycheck to paycheck before their illness or injury, and those whose illness … Continued

The No Surprises Act IDR process has had many starts and stops this year, creating even a greater backlog of cases. Needless to say, it has not been a smooth roll out. During the period between April 15, 2022 and June 30, 2023, 490,000 disputes were initiated — more than 22 times the amount of … Continued

As federal health initiatives go, the botched rollout of the No Surprises Act (NSA) Independent Dispute Resolution (IDR) process almost rivals that of Health Reform. Just one decade ago, on October 1, 2013, the healthcare.gov website went live, and crashed within two hours after successfully registering 26 people across the entire United States population – … Continued

Financially fragile workers are highly vulnerable to current economic conditions.[i] Most live paycheck to paycheck. Most have little to no savings. Most lack a financial safety net and do not have resources on hand to meet even a $1,000 unexpected expense.[ii] Rapid inflation compounds existing financial fragility for this segment of Americans who are unprepared … Continued

Annual enrollment typically occurs in November and December each year.  Over this period, workers have the opportunity to review options, make changes to current benefits elections and enroll in new  benefit options or programs. Christine Cooper, CEO of aequum, urges plan sponsors and their benefits administrators to plan for a “health and wealth” strategy as … Continued

With annual open enrollment approaching, employers and employees alike are at heightened levels of stress over the potential for significant increases in benefit costs. End-of-year health plan renewals may see significant increases in the cost of coverage, potentially resulting in higher employer and employee contributions and/or higher point of purchase cost sharing (deductibles, copayments, etc.). … Continued

The federal government prevailed at summary judgment in a case brought by the Association of Air Medical Services (the “Association”) against the U.S. Department of Health and Human Services et al. (“HHS”), marking it the government’s first major victory in the string of court challenges to the No Surprises Act (the “NSA”). No Surprises Act … Continued