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Enforcement of No Surprises Act good faith estimate requirements to include co-provider GFEs delayed, pending further rulemaking

The U.S. Department of Health and Human Services (HHS) issued an FAQ today announcing that the the agency has extended discretion on enforcement of the No Surprises Act good faith estimate (GFEs) requirements for uninsured (or self-pay) patients for situations where the estimates do not include expected charges from co-providers or co-facilities.

This announcement directly affects compliance requirements for hospital-based radiologists. 

HHS had earlier indicated that it would exercise its enforcement discretion through December 31, 2022 in situations where a GFE provided to an uninsured (or self-pay) patient did not include expected charges from co-providers or co-facilities. It had been expected that enforcement would begin on January 1, 2023. 

In today's FAQ, HHS reported that it received comments and feedback indicating that compliance with the co-provider provision is likely not possible by January 1, 2023, "given the complexities involved with developing the technical infrastructure and business practices necessary for convening providers and facilities to exchange GFE data with co-providers and co-facilities." 

The agency made clear in the FAQ to expect further rulemaking regarding a prospective date when providers and facilities will be excepted to comply with any new requirements relating to co-provider GFEs.

By extending this exercise of enforcement discretion, HHS aims to promote further interoperability across the health care industry and encourage providers, facilities, and other industry members to focus resources towards adopting interoperable processes for exchanging information.

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health care & life sciences, no surprises act

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