Yes, No or Maybe: Will New Rules Lower Your Medical Costs

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: Litigation Continues

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

What Employers Can Do to Help Stem Rising Medical Debt

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

No Surprises Act Arbitration Update

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

Total Health Benefit Costs Projected to Rise In 2024, According To Mercer National Survey

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

Federal Court Rules Against Association of Air Medical Services: A Win for Patients and Payers and a Huge Loss for Air Ambulance Companies

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

Survey Reveals Provider Frustrations Over No Surprises Act, Alleges Payers Ignore Independent Dispute Resolution Rulings

While the No Surprises Act (NSA) intends to end surprise medical billing, also known as balance billing, and protect patients from receiving high out-of-network charges in certain situations, there remain challenges with enforcement over rulings made through the Independent Dispute Resolution (IDR) process. A new survey conducted by the Americans for Fair Health Care (AFHC) … Continued