NEW PROPOSED RULE ON AIR AMBULANCE SERVICES, AGENT AND BROKER DISCLOSURES AND PROVIDER ENFORCEMENT ANNOUNCED BY SEVERAL AGENCIES
October 8, 2021
On September 10, 2021 the Department of Health and Human Services (“HHS”), Department of Labor (“DOL”), and Department of the Treasury, along with the Office of Personnel Management (“OPM”) announced their intentions to issue a notice of proposed rulemaking, available here, to implement additional components of the No Surprises Act and the Consolidated Appropriations Act of 2021.
The proposed rule focuses on three main issues (1) the reporting/submission of information about air ambulance services by air ambulance providers, insurers, group health plans, and Federal Employee Health Benefits carriers; (2) the process HHS should take to investigate and enforce violations of federal insurance law; and (3) the implementation of a provision of the Consolidated Appropriations Act that requires insurers to disclose the amount they pay in direct and indirect compensation to agents and brokers for enrollment in individual market coverage and short-term, limited duration insurance.
The proposed rule would require plans, issuers, and providers of air ambulance services to submit detailed data in regard to air ambulance services specified in the reporting requirements of the No Surprises Act, and would give authority to the Centers for Medicare & Medicaid Services to fully enforce Title I of the Act and Title II of Division BB of the Consolidated Appropriations Act. The proposed rule would also provide a process that HHS would use to investigate complaints and potential violations of Public Service Health Act provisions and if necessary, would also allow the agency to take enforcement action, which includes the imposition of civil penalties, against facilities and providers of air ambulance services for failure to submit some or all of the required air ambulance claims data to HHS. The proposed rule would also require all entities, including air ambulance providers, group health plans, insurers, and Federal Employee Health Benefits carriers would be required to submit reports on air ambulance services by March 31, 2023 and March 30, 2024. In addition to this, the proposed rule also provides a more detailed description of the process that the Centers for Medicare & Medicaid Services would be able to use to determine if states are adequately enforcing the new surprise billing protections and taking action against providers that continue to issue surprise bills to patients.
The new rule is being proposed as President Biden’s administration is looking to do more to protect patients from high costs and make health care more affordable. The agencies are seeking comments on the proposed rule until October 13, 2021.
If you have any questions, please contact Evelyn Sahr (esahr@eckertseamans.com or 202-659-6622); Drew Derco (dderco@eckertseamans.com or 202-659-6665), or Andy Orr (aorr@eckertsemans.com or 202-659-6625).
Share This Post
Authors
