End of Year NSA Compliance Updates
As many of the No Surprise Act (NSA) requirements are effective on or after January 1, 2022 for group health plans and issuers, we are providing a status update on our efforts to assist your plan with compliance.
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Independent Dispute Resolution Process
On September 30, 2021, the U.S. Departments of Health and Human Services (HHS), Labor and Treasury (collectively, the Departments) along with the Office of Management and Budget released “Requirements Related to Surprise Billing: Part II,” to provide additional guidance on the Consolidated Appropriations Act (CAA).
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Proposed Regulations for Implementing the NSA
On September 10, 2021, the Health and Human Services Department (HHS), the Personnel Management Office (PMO), the Internal Revenue Service (IRS), and the Employee Benefits Security Administration (EBSA) issued a proposed rule to implement additional components of the No Surprises Act (NSA) and the Consolidated Appropriations Act, 2021 (CAA). Comments are due 30 days after publication in the Federal Register, October 18, 2021.
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DOL, HHS & Treasury FAQ's
In this week’s WebTPA Compliance Update, we provide updates to key portions of recent federal legislation and recap on major requirements of this legislation.
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Federal Legislation for Self-Funded Health Plans
WebTPA is committed to keeping its clients up to date on federal healthcare policies and legislation. Here you will find our interpretation of said legislation and how these statutes may impact your health plan.
Publicly Available, Machine-Readable Files
In-Network Rates and Historical Out-of-Network Allowed Amounts
To meet transparency requirements effective July 1, 2022, WebTPA will assist plan sponsors in making the two machine-readable files available (in-network rates for covered services or item covered by the plan, historical billed charges from out-of-network providers and the allowable amount of such charges considered by the plan).
Important Note
These are very large JavaScript Open Notation (JSON) files (20GB to 70GB) that may take a while to download. If your system has limited capability, they may not be downloadable. Download speeds and time are dependent on your internet speed, browser and computer hardware.
