No Surprises Act Challenges, Positive Developments and More Hidden Info

In a conversation with Becker’s Healthcare Payer Issues Podcast, Bracewell’s Carrie Douglas gave insights on the developments under the No Surprises Act (NSA), including concerns with the NSA arbitration process from a provider perspective and initial thoughts on the Fed's proposed changes to the NSA process.

“The biggest challenge we’re seeing with the NSA is once the claim has been adjudicated with the IDRE, and we have what’s called a disposition, the payers aren’t paying," said Douglas.

"There’s no really great vehicle in order to get them to pay. So, what we’re seeing is some of these wins are significant and yet we can’t get them funded, so that’s having a huge impact on our financial revenue cycle stream. It’s having a huge impact on the ability to continue operations because when you’re having delays in getting funded, it’s an unhealthy balance sheet essentially. So, we have these really great paper victories out there for the providers that the payers aren’t being able to pay them timely," Douglas added.

Click here to listen to the entire podcast.