#AskAOA: No Surprises Act Update
In fall 2021, the Department of Health and Human Services (HHS) released new regulations implementing the No Surprises Act. The No Surprises Act is aimed at addressing situations in which patients receive surprise medical bills when they inadvertently or unknowingly receive care from an out of network provider. The Departments of Health and Human Services (HHS), Treasury, and Labor have developed several regulations to implement the law.
In addition to addressing emergency care situations, one provision addressed in regulation requires that good faith estimates (GFE) be provided to uninsured patients when requested or when an uninsured patient schedules a visit. The regulations released in fall 2021 were unclear with regard to what types of health care providers would be required to provide GFEs. Given a lack of clarity in the interim final rule issued in fall of 2021, the AOA and other associations such as the American Medical Association have been seeking clarity from HHS on the applicability of the GFE requirements on individual physician practices.
Following AOA's outreach, on Dec. 27, 2021, HHS clarified that “Generally, all providers and facilities that schedule items or services for an uninsured (or self-pay) individual or receive a request for a GFE from an uninsured (or self-pay) individual must provide such individual with a GFE. No specific specialties, facility types, or sites of service are exempt from this requirement.”
The AOA has serious concerns about the recently provided clarifying information from HHS on applicability of the rule to doctors of optometry and has asked HHS for a delay of implementation of this rule to consider additional feedback from physician practices.
We have updated our Frequently Asked Questions document, but also urge all doctors of optometry to take these steps today:
Look for additional updates on these regulations from AOA. We have serious concerns with the implementation of this rule and are seeking a delay in implementation.
Familiarize yourself with the good faith estimate requirements. Please note that HHS has indicated they will be exercising some enforcement discretion in 2022 and HHS also plans to provide opportunities for additional education and training on these requirements.
Attend the #AskAOA Webinar on Jan. 24 at 9 p.m. ET. The webinar will be provided by Jeff Michaels, O.D.
Dr. Michaels will also provide a brief update on Provider Relief Fund Reporting that is required in Q1 2022.
If you would like to submit a question to be addressed during the webinar, please send it to firstname.lastname@example.org.