Surprise Balance Billing
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Comments on No Surprises Act Rulemaking: Part I
Schaeffer Initiative experts offer comments on an interim final rule (IFR) issued by the Departments of Health and Human Services, Labor, and the Treasury implementing provisions of the No Surprises Act.
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“Equal Weighting” is a Poor Framework for Arbitration Decisions Under the No Surprises Act
If arbitrator are required to consider or weigh the various factors “equally” under the No Surprises Act, it would be close to meaningless and leave arbitrators without an actionable framework for making decisions. A lack of clear guidance would be costly—resulting in excessive use of arbitration, excessive payments to providers, and, in turn, excessive premiums.
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Commercial and Medicare Advantage Payment for Anesthesiology Services
This study compares payments for common outpatient anesthesiology services by commercial health plans, Medicare Advantage (MA), and traditional Medicare.
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Congress Ends Surprise Billing Implications for Payers, Providers and Patients
The No Surprises Act represents a rare bipartisan moment for Congress and a long-needed safeguard for patients that will reorient relationships among payers and providers.
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Our Work In Surprise Balance Billing
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Emergency Physicians Recover a Higher Share of Charges from Surprise Medical Bills
Emergency physicians recover a higher share of charges from out-of-network care than from in-network care.
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The Unfinished Business of Air Ambulance Bills
An overview in Health Affairs of the newly passed No Surprises Act and how the legislation will regulate surprise air ambulance bills.
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Recommendations for Implementing the No Surprises Act
Schaeffer Initiative experts examine several key implementation questions within the No Surprises Act and discuss options for resolving those questions.
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Understanding the No Surprises Act
A look at the No Surprise Act, a new federal law that ends surprise out-of-network billing. The law was passed late last year as part of the omnibus bill.
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Arbitration Over Out-Of-Network Medical Bills: Evidence From New Jersey Payment Disputes
Arbitrators seemed to anchor decision around surprising billing to the 80th percentile of charges with the median decision being 5.7 times prevailing in-network rates for the same services.
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Arbitration Decisions in New Jersey Surprise Billing Cases Result in Large Payouts
The mean award was 9 times higher than the median in-network price for the same services.