Lexology July 30, 2021
Passed in December 2020, the Consolidated Appropriations Act, 2021, (CAA) included provisions that address group health plan price transparency provisions, reporting, disclosure, and other patient protections. The price transparency rules are slated to become effective on January 1, 2022, so employers should be working with their carriers or TPAs on compliance efforts soon.
Advance EOB Requirements
The CAA requires that health plan participants receive an advance explanation of benefits (EOB) whenever they schedule a health care service at least three business days in advance. Participants are also able to request an advance EOB for a health care service whether or not the service has been scheduled.
For services scheduled at least three business days in advance, providers must give the...
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