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CMS Delays Enforcement of Surprise Billing Co-Provider Requirement

The Centers for Medicare & Medicaid Services (CMS) will not enforce a surprise billing requirement that requires good faith estimates (GFEs) for uninsured and self-pay patients to include cost estimates from co-providers and co-facilities.

Included in Requirements Related to Surprise Billing; Part II, which implements the No Surprises Act, the provision was set to take effect Jan. 1, 2023. In a Dec. 2 frequently asked questions (FAQ) document, CMS states it has received extensive feedback that compliance with this provision will not be possible by the beginning of 2023, given the complexities involved in developing the technical infrastructure and business practices to exchange this data. The agency does not give a new deadline for this requirement.

Beginning Jan. 1, 2022, all providers were to provide uninsured or self-patients a GFE, regardless of the type or amount of financial assistance given to the patient. For further details on GFE requirements, see the December 2021 FAQ.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Julie Kozminski is a senior policy analyst at America's Essential Hospitals.

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