New federal health insurance regulations

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