The No Surprises Act came into effect in January of 2022. Two years later, it remains a moving target. The Texas Medical Association (TMA) successfully challenged several provisions in the regulations implementing the NSA. Most recently, and notably, they secured the TMA III decision that the QPA calculation requirements unfairly favored insurers. The Departments of Labor, and Health and Human Services have issued new proposed rules in response. This session will provide plans with insights on the impact of these decisions, how future rulemaking is shaping up, and trends in IDR provider strategies.

• Examining Texas Medical Association challenges to provisions in the NSA and the implications for the IDR process moving forward
  • Examining changes to fees, batching restrictions, QPA calculations
• Reviewing federal and state enforcement of surprise billing laws
  • How CMS is approaching QPA audits
• Analyzing IDR outcomes for payors since the implementation of the process
  • Tracking how the process is performing to date in different states
  • Examining emerging plaintiff side strategies
  • Air ambulance litigation update on actions challenging IDR awards