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Improper payments increased by $31 billion in fiscal 2020 as compared to 2019. New data from the Office of Management and Budget shows agencies improperly paid out $206 billion last year up from $175 billion in 2019. Of that $206 billion, OMB said agencies determined they could recapture almost $47 billion. In the end, agencies brought back about 47%, or about $22 billion to the Treasury after overpaying citizens or businesses. OMB gave agencies new guidance in March to further implement the Payment Integrity Information Act of 2019.
HHS Issues First Regulations Related to Surprise Billing
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Biden Administration Release Part 1 of its Regulations Targeting Surprise Billing | Mintz - Health Care Viewpoints
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Tuesday, July 6, 2021
SUMMARY
On July 1, 2021, the US Departments of Health and Human Services (HHS), Treasury and Labor, and the Office of Personnel Management issued an Interim Final Rule with comment (IFR) implementing portions of the No Surprises Act, legislation enacted in December 2020 that bars surprise billing beginning January 1, 2022.
Under the law, payers and providers (including hospitals, facilities, individual practitioners and air ambulance providers) are prohibited from billing patients more than in-network cost-sharing amounts in certain circumstances. The prohibition applies to both emergency care and certain non-emergency situations where patients do not have the ability to choose an in-network provider.
The law establishes a pathway for resolving payer-provider payment disputes using negotiation and arbitration. If entities are unable to come to an agreement, the independent dispute resolution (IDR) process requires each party to submit a final pay
Rule Aims To Protect Consumers From Surprise Medical Bills
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