Now I See You! Medical Billing Transparency and other Rules of the No Surprises Act

There’s lots to learn about the new requirements for health plans, health insurance issuers, and providers regarding cost transparency, balance billing, and other matters imposed under the Transparency in Coverage rules (extending rules of the Patient Protection and Affordable Care Act (ACA)); the No Surprises Act (enacted as Title I of Division BB of the Consolidated Appropriations Act, 2021 (CAA) (Pub. L. No. 116-260)); and other rules enacted under CAA, Division BB, Title II.

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• Employee Benefits & Executive Compensation Key Legal Developments Tracker
  Stay informed on new developments.
  • Retirement Plans. IRS announces proposed rules, pursuant to the SECURE Act, on an exception to the unified plan (or “one bad apple”) rule available for qualified multiple-employer plans (MEPs) offered by a pooled plan provider (or for which all employers have another common interest) such that noncompliance by one participating employer will not result in full plan disqualification if certain conditions are met. 87 Fed. Reg. 17,225 (Mar. 28, 2022).
  • Health and Welfare Plans. CMS extends until further notice its non-enforcement policy (otherwise due to expire 10/1/22) allowing grandfathered health insurance policies and plans in the individual and small group market to continue exemption relief from certain healthcare reform requirements. CMS, Extended Non-Enforcement of ACA-Compliance with Respect to Certain Policies.
  • Health and Welfare Plans. IRS, in consultation with DOL and HHS, issues guidance under the No Surprises Act on rules for determining 2022 qualifying payment amounts when a plan or policy lacks relevant historical claims data. I.R.S. Notice 2022-11.
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