Where we’re going

On February 23, 2022, Eastern District of Texas Judge Jeremy Kernodle sided with the Texas Medical Association (TMA), a trade association representing more than 55,000 physicians, and decided that the Department of Health and Human Services (HHS) interim final rule governing the Independent Dispute Resolution (IDR) process conflicted with the No Surprises Act by creating … Continued

February Wise Healthcare Consumer Month February is recognized as National Wise Health Care Consumer Month, established by the American Institute for Preventive Medicine. By raising awareness and opening dialogue, the Institute intends to make a long-term impact on the way healthcare consumers take personal ownership of their care.    Healthcare Consumerism Healthcare consumerism is a growing … Continued

It may surprise you to learn that employer-sponsored, self-insured health plans live squarely at the intersection of business success and the goal of health equity. Health Savings Accounts (HSAs) play a critical role in the success of each. What is Health Equity? Let’s start by understanding the effects of a lack of health equity. Inequities … Continued

Today the California State Assembly will vote on a proposal – AB No. 1400 — to create a single-payer healthcare system. They system would be similar to Medicare: a fee-for-service model. It would eliminate premiums, copays and deductibles. It would provide broad coverage, including: inpatient and outpatient, emergency and non-emergency medical and health facility and … Continued

Join Jack Towarnicky, with Humaculture’s Steve Cyboran, Wes Rogers and Kelley Long on Thursday, February 17, from 12:00 to 12:30 CST as they present the second installment of the Hidden Opportunities, Strategic Compliance Series. They will reconfirm why “unexpected” bills does not always mean “surprise” bills and demonstrate why Health Savings Accounts (HSAs) are a … Continued

Jack Towarnicky, member of aequum, recently presented as a guest speaker during Humaculture’s Hidden Opportunities, Strategic Compliance Series. This was the first of a five-part series of monthly webinars that offer guidance to plan sponsors and third-party claims administrators on how to strategically respond to the No Surprises Act (NSA) and Transparency in Coverage requirements. … Continued

Part I of the Requirements Related to Surprise Billing require cost-sharing amounts for emergency services provided at nonparticipating emergency facilities or by nonparticipating providers or non-emergency services provided by nonparticipating providers at participating facilities to be based on the lesser of the billed charge or the Qualifying Payment Amount (QPA) where an All-Payer Model Agreement … Continued

With the New Year approaching, you may be wondering will the No Surprises Act really go into effect on January 1st (at least the parts that have not already been delayed)? The answer for now is YES. But, with four lawsuits pending in three courts, this could change at a moment’s notice. Here is a … Continued

And the lawsuits have started… The Texas Medical Association (TMA) was the first to challenge the No Surprises Act. On October 28, 2021, TMA filed a Complaint in the United States District Court for the Eastern District of Texas seeking to vacate certain provisions of Part I of the Requirements Related to Surprise Billing (Part … Continued

On October 7, 2021, the Department of the Treasury, Department of Labor, and Department of Health and Human Services drafted and published Part II of the Requirements Related to Surprise Billing, which establish the Independent Dispute Resolution process. The most interesting development arising out of Part II relates to the discretion (or lack thereof) provided … Continued