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No Surprises Act: What does my office need to know? As of January 1, 2022, providers and facilities must comply with a number of requirements established by the federal No Surprises Act (NSA) . The NSA prohibits out-of-network health care providers and facilities from balance billing commercially insured patients, in certain circumstances. Part II of the NSA, the “Requirements Related to Surprise Billing; Part II” is most applicable to chiropractic physician offices and was created to provide additional protections against surprise medical bills, including: • Requiring good-faith estimates of medical items or services for uninsured (or self-paying) individuals. • Requiring notice posted in your office and on your website of the uninsured/self-insured’s right to receive a good faith estimate. • Establishing a patient-provider dispute resolution process for uninsured (or self-paying) individuals to determine payment amounts due to a provider or facility under certain circumstances. The series of Rules lay the groundwork to provide consumers with protection against surprise billing, starting in 2022. Learn more about how these rules help consumers. This FCA Toolkit will focus on that part of the NSA most applicable to chiropractic offices – Part II: Good faith estimates (GFEs) for self-pay and uninsured patients and will address what physicians must address immediately to be compliant with the new requirements. The NSA impacts all offices in some way since the minimum requirements will include asking required questions of patients; placing posters in your office; notices on your website; and paperwork for Medicare patients.
Senate Advances No-fault/PIP Replacement By FCA Government Affairs Director Jack Hebert, General Counsel Kim Driggers and General Counsel Emeritus Paul Lambert Thursday, February 3, 2022, Tallahassee – It took the Senate Banking and Insurance Committee just ten minutes at the end of their meeting yesterday morning to hear, consider, debate and vote on a controversial proposal seeking to repeal and replace Florida’s No-fault auto insurance system with a requirement the drivers carry mandatory bodily insurance (MBI) instead. Even more astonishing was the pronouncement by committee Chairman Jim Boyd (R-Bradenton) that no public testimony would be allowed on Senate Bill 150 given the large number of appearance requests the committee had received. Audience members were not the only ones taken aback. Committee member Jeff Brandes (R-St. Petersburg) called the abbreviated exercise “essentially, in my opinion, legislative malpractice,” further expressing his dismay that Senators were being asked to vote on an issue that would affect over 12 million Floridians without knowing how it’s going to impact premium rates. Brandes also questioned if further research or studies on the potential effects of the changeover had been commissioned after the Governor vetoed the similar measure passed by the Legislature last spring. Prime bill sponsor Sen. Danny Burgess (R-Zephryhills) responded, “We have not.” Brandes later concluded, “The fact the Legislature would produce a bill and not provide a study to back the bill at this level is tantamount to malpractice.” The bill introduced this session is essentially the same bill passed last session with one major change: This newest version would require policyholders to “opt in” to accept optional medical payments coverage (MedPay) insurers would have to offer. Last year’s version instead had a provision allowing drivers to “opt out” of a mandatory offer of MedPay coverage. Burgess claimed he believed this adjustment would have the effect of reducing premiums enough to offset the rate hike suggested by the 2021 study which, in his opinion, was otherwise “fundamentally flawed.” The Committee moved quickly to pass the bill 10-to-1 with Brandes casting the lone dissenting vote. The proposal next moves to the Senate Judiciary Committee, its second of three committee references. A similar House bill, HB 1525 by Rep. Grall (R-Vero Beach) remains in its first committees of reference, awaiting scheduling for its first public hearings. The FCA remains opposed to the repeal of No-fault/PIP and was on hand planning to testify at the hearing before the chair decreed there would not be an opportunity for the committee to listen to any public comments. |