No Surprises Act: How’s Your Response So Far — Strategic or Solely Compliance?

Two months ago, Jack Towarnicky of aequum joined Steve Cyboran and Wes Rogers of Humaculture in the first of five monthly webinar series to highlight new opportunities prompted by the No Surprises Act and Consolidated Appropriations Act.

The next 30 minute session is Today, March 17th, when Jack will be joined by Steve, Wes and Scott McKibbin in presenting: Hidden Opportunities: A “Dope” Response to Pharmacy “Transparency”

So, how’s your response so far? Have you focused solely on complying with the No Surprises Act? Or have you decided to investigate how you might take advantage these new requirements?

In the first session on January 20, Jack highlighted the No Surprises Act’s impact on plans that use provider networks. The recommended strategic response suggested plan sponsors consider adopting Reference Based Pricing (RBP) – but not only for out-of-network providers, but to also consider creating a “pure” RBP structure.

Given the wide variation of provider charges for the same services, often without any difference in quality, a pure RBP design, coupled with aequum’s participant representation services, offers you an opportunity to avoid excessive and unreasonable provider fees and charges – to reduce eligible expenses which will, in turn:

  • Immediately lowers participant out-of-pocket costs
  • Lowers the cost of coverage, today and in the future – lowering employer and employee contributions


Your Partner

To minimize spend and maximize quality, patients need transparent price and billing information before consenting to medical services. aequum helps plan sponsors and administrators add this protection through our software and data-driven solutions. aequum ensures participants have the strongest defense should there be a dispute over unreasonable or excessive provider charges. As your partner, we are here to address your concerns and help you and your plan participants succeed in 2022 and beyond. Please contact us if you have any questions or need for support.