Healthcare Finance News February 3, 2023
Susan Morse, Executive Editor

For hospitals, the NSA’s baseball-style arbitration has struck out as claims are backlogged in the independent dispute resolution process.

The No Surprises Act, which was signed into law in 2020 and went into effect on January 1, 2022, aimed to take patients out of billing conflicts between providers and payers. By all accounts, this part of the law has been successful in preventing patients from getting a surprise medical bill when they see an out-of-network physician at an in-network hospital.

But for providers and payers, the No Surprises Act has created a quagmire of questions and litigation over how the Qualifying Payment Amount is reached and more importantly, who gets to decide.

Attorney Gary Qualls, a K&L Gates Health Care...

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