AMA Toolkit
Preparing for implementation of the No Surprises Act
The No Surprises Act prohibits out-of-network healthcare providers and facilities from balance-billing commercially insured patients, in certain circumstances. The Act and its implementing regulations set a method for determining the patient cost-sharing for these out-of-network situations, and when state law does not establish a provider payment methodology, the Act establishes an independent dispute resolution (IDR) arbitration system to establish provider payment.
This toolkit focuses on three operational challenges that physicians will need to address immediately to comply with the new requirements: non-emergency services at in-network facilities; emergency services and post-stabilization care at hospitals or freestanding emergency departments; and good faith estimates for self-pay and uninsured patients.
Download the toolkit: https://www.ama-assn.org/system/files/ama-nsa-toolkit.pdf.
