Compliance Perspectives

By Adam Turteltaub The No Surprises Act is a significant change to how healthcare coverage is handled and billed. In general, it eliminates balance billing in three typical areas: A patient is brought to an emergency room in an out of network hospital A patient is transported by air ambulance A patient is being cared for at an in-network hospital but, unbeknownst to him or her, a physician or service that is out of network provides care. To understand the Act more fully, we spoke with Brian Stimson, Partner, Arnall Golden Gregory, who will be leading the session The All Surprises Act:  Avoiding Compliance Pitfalls and Responding to Administrative Enforcement Actions under the Surprise Billing Laws at the 2024 HCCA Compliance Institute. As he explains, there is a two-tiered enforcement structure to the law, with both individual states and the federal government involved. Compliance teams looking to ensure their organizations are complying need to pay close attention to patient complaints. These can