Bloomberg Law
July 6, 2021, 9:23 AM

Employers, Insurers Get Upper Hand in Surprise Billing Rule

Sara Hansard
Sara Hansard

Employer groups are happy with the first rule implementing a law aimed at protecting patients from large “surprise” bills from emergencies and hospital procedures. It appears to keep payment rates lower than what medical providers were calling for.

The interim final rule (RIN 0938-AU63) released July 1 by four agencies lays out how payments from health plans to providers will be determined in emergencies as well as for care at facilities that are in patients’ insurance networks from clinicians who aren’t. It implements part of the No Surprises Act passed as part of appropriations legislation (H.R. 133) in ...

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