Gain an understanding of surprises balance billing, the problems it causes, and the ways the No Surprises Act attempts to address those problems.
This topic is designed to explain the No Surprises Act, including its history, the important problems the Act tries to solve, and how it attempts to solve those problems. Surprise balance billing has been a hot-button issue in state and federal politics for many years. The No Surprises Act radically changes the status quo for health plans, health care providers, and patients with respect to out-of-network care for emergency services, non-emergent services provided by out-of-network providers at in-network facilities, and air ambulance services. The Act goes into effect on January 1, 2022. Health care providers may be subject to steep fines if they impermissibly balance bill patients, and they may be unable to collect additional payment if they do not comply with specific requirements to submit claims to arbitration. Health plans are regulated in new ways that may impose additional financial liability for out-of-network claims. This material will provide you and understanding of the new requirements, challenges of implanting the Act, and strategies to adapt to the new way of paying for these out-of-network services.
Agenda
Faculty
Kristopher R. Alderman
FisherBroyles LLP
- Partner with FisherBroyles, LLP
- Litigates cases in state and federal court; represents health plans, fiduciaries, third-party administrators, individuals, and plan participants and beneficiaries in ERISA and managed care cases
- Has represented clients in cases involving claims for ERISA benefits, allegations of breaches of fiduciary duty, COBRA rights, Section 510 employment discrimination, assignments of benefits, and preemption; he also advises clients on matters related to plan design, ACA compliance, and self-funded plan options
- Extensive experience representing clients in matters involving health care reimbursement; he defends individuals against balance billing by medical providers; well-versed in health care economics and finance; he also represents employers, health plans, plan administrators, fiduciaries, and claims administrators in health care reimbursement matters
- Represents patients across the country in hospital billing disputes at no charge to the patient
- He represents and advocates for his clients’ interests under consumer protection laws, including the Fair Debt Collection Practices Act, the Fair Credit Reporting Act, and deceptive trade practices laws
- Has extensive experience representing and advising clients with respect to hospital liens and subrogation rights
- Also represented clients in a wide variety of employment matters, including claims arising under Title VII, ADA, ADEA, FMLA, and ERISA
- J.D. degree, magna cum laude, Georgia State University College of Law; B.A. degree in English, cum laude, University of Georgia
- •Can be contacted at 404-596-8887 or [email protected]
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