Where we’re going

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

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

Compliance with the No Surprises Act (NSA) remains a priority for employer-sponsored health plans The NSA ends surprise medical billing, also known as balance billing, in certain situations – such as emergency care or services from out-of-network providers at in-network facilities. Physicians and other payers continue to challenge agency regulations implementing NSA, specifically provisions that … Continued

Advance Transparency in Coverage (TiC) rules require employers to provide employees with easy access to an online shopping tool featuring 500 shoppable services and highlighting personalized out-of-pocket cost information for covered healthcare items and services. These pivotal transparency mandates are intended to spearhead a massive shift in the role of the patient as a healthcare … Continued