During 2020, the federal government enacted several health care regulations, many of which apply to health insurance
These regulations fall into three main categories:
- Consolidated Appropriations Act of 2021 - including the ‘No Surprises Act’ to protect consumers from certain surprise medical bills
- Price Transparency - providing rules intended to promote clear and accessible pricing information
- Interoperability – a number of data exchange projects designed to improve the ability of a patient to electronically access their health care information and also increase the portability of a patient’s health care information.
We have a full compliance and implementation team staying ahead of the evolving regulations. Most regulations do not require any action by fully insured employer groups or members. For self-funded employer groups, BCBSND is providing significant assistance as outlined below to facilitate full and timely compliance with the regulations.
Spotlight mandate articles:
Consolidated Appropriations Act—Including no surprise billing legislation: Part one
Update on Cost-sharing transparency on identification cards
New requirements for out-of-network provider reimbursement disputes
Update member cost-sharing calculation for No Surprises Act items and services
Balance billing consent and new disclosure added to EOB
New independent dispute resolution process for out-of-network provider reimbursement disputes