Health Care Today | Health Law Blog

Since the No Surprises Act was signed into law in 2020, the Department of Health and Human Services has published several rules with respect to the Act, leaving many unanswered questions. With the Act taking effect this month, forums are now being held to educate providers on the new law, which curtails surprise medical bills from out-of-network providers.

The No Surprises Act, which then-President Trump signed into law on December 27, 2020, as part of the Consolidated Appropriations Act of 2021, addresses surprise medical bills from out-of-network providers when patients believe they are seeking care from in-network providers. Most sections of the act go into effect on January 1, 2022, and the Departments of Health and Human Services, Treasury, and Labor are working on regulations to implement many provisions of the act.

If an offer to a health care provider to speak at or attend a pharmaceutical or medical device company’s event seems too good to be true – it probably is, and it could lead to civil, criminal and federal administrative penalties.  

On March 27^th, 2020, President Trump signed into law the Coronavirus Aid, Relief and Economic Security Act, also known as the CARES Act (“Act”). The Act is a massive piece of legislation, covering a number of aspects of economic life, including programs to maintain employment, assist workers, families and businesses, supporting the health care system, and providing assistance to distressed sectors of the U.S. economy.

On March 17, 2020, the Office of Inspector General (“OIG”) issued a Policy Statement that will provide yet another avenue of relief from regulatory requirements as health care providers across the nation deal with the COVID-19 public health emergency.

This specific action by the OIG relieves physicians and other health care practitioners from administrative sanctions if they reduce or waive any cost-sharing obligations from federal health care beneficiaries seeking telehealth services.

There has been a lot of movement throughout the country on the state level to prevent patients from receiving surprise medical bills when they receive unanticipated care from out-of-network providers while seeking care from in-network providers. For example, in 2018, Missouri passed such legislation, which banned surprise medical bills for patients who are treated by an out-of-network physician at an in-network emergency room.

On April 23, 2019, the U.S. Department of Health & Human Services (HHS) published a Notification of Enforcement Discretion Regarding HIPAA Civil Money Penalties (CMP) outlining interim annual limits for HIPAA violations. HHS believes the revised annual limits “reflect the most logical reading of the HITECH Act.” These amounts are subject to change pending further rulemaking.

In November 2018, Missouri became the 33^rd state to approve the use of medical marijuana, and rules and regulations for medical marijuana are being drafted by the Missouri Department of Health & Senior Services (DHHS). On March 15, 2019, DHSS released more draft rules. Of the published draft rules, there is only one set that relates to physician certifications. However, hospitals and other health care providers will encounter numerous challenges once medical marijuana becomes available in Missouri in 2020.