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The latest insights on U.S. healthcare policy from MD Clarity.

Healthcare Policy

Sliding Fee Discounts in Good Faith Estimates: What FQHCs Need to Know

Rex H.

Published: Jun 01, 2023

Updated:

Discover how sliding fee discounts work in good faith estimates. Understand how sliding fees work with PPDR.

Healthcare Policy

Updates to CMS Hospital Price Transparency Enforcement in 2023

Rex H.

Published: May 12, 2023

Updated:

Explore the recent updates to CMS Hospital Price Transparency enforcement, understand the changes in compliance requirements, and the implications for hospitals.

Healthcare Policy

Current Policies for Prior Authorization: Why They’re Likely Changing in 2023

Rex H.

Published: Mar 20, 2023

Updated:

Learn about current policies for prior authorization and what proposals are on the table to change them in 2023.

Healthcare Policy

Abbreviated Good Faith Estimate for No-Cost Healthcare: Requirements & Template

Rex H.

Published: Feb 22, 2023

Updated:

Learn the requirements and get the template for the abbreviated good faith estimate that is designed for no-cost healthcare services.

Healthcare Policy

HCPCS Codes: Everything You Need to Know

Rex H.

Published: Feb 14, 2023

Updated:

Learn the ins and outs of HCPCS codes - from modifiers to recent No Surprises Act regulations - in our free guide.

Healthcare Policy

ASP Drug Pricing in Healthcare: What Providers Need to Know in 2024

Rex H.

Published: Jan 27, 2023

Updated:

Learn about ASP drug pricing in healthcare and how it's been impacted by the Inflation Reduction Act.

Healthcare Policy

IDR Administrative Fees: What’s Changed in 2023

Rex H.

Published: Jan 23, 2023

Updated:

An increase in IDR administrative fees is in effect as of January 1, 2023. Learn why they were increased and what's been proposed to make it more balanced for providers.

Healthcare Policy

All-Payer Claims Databases and the No Surprises Act: What You Need to Know

Rex H.

Published: Jan 13, 2023

Updated:

Get informed on the latest about All-Payer Claims Databases (APCDs) and how they relate to the No Surprises Act. Learn how it aims to reduce healthcare costs and increase transparency for patients.

Healthcare Policy

Good Faith Estimates and Patient Medical Records: What You Must Know

Rex H.

Published: Jan 04, 2023

Updated:

Find out what federal regulations say about Good Faith Estimates and their relationship to patient medical records.

Healthcare Policy

Transparency in Coverage Final Rule

Rex H.

Published: Dec 19, 2022

Updated:

Learn how the Transparency in Coverage final rule is designed to facilitate open pricing in healthcare and what it means for patients and providers.

Healthcare Policy

Qualifying Payment Amount (QPA): A Comprehensive Guide

Rex H.

Published: Dec 16, 2022

Updated:

The Qualifying Payment Amount (QPA) is a critical part of billing disputes in the No Surprises Act. Learn how it's calculated and other details in our guide.

Healthcare Policy

HB22-1285: Colorado Hospital Price Transparency Law

Rex H.

Published: Dec 14, 2022

Updated:

Colorado's HB22-1285 law promotes price transparency. Find out what rules hospitals have to follow to avoid collection prohibitions.

Healthcare Policy

Good Faith Estimates for Insured Patients: What We Know So Far

Rex H.

Published: Dec 09, 2022

Updated:

Are good faith estimates required for insured patients? Learn what the status is and other regulations that apply to consumers with insurance.

Healthcare Policy

The No Surprises Act and Dental Care: Don’t Be Surprised When It Affects You

Rex H.

Published: Dec 05, 2022

Updated:

Does the No Surprises Act apply to dental care? Learn what regulations dentists must follow.

Healthcare Policy

No Surprises Act Enforcement 2024: Is Your Healthcare Organization Prepared?

Rex H.

Published: Nov 28, 2022

Updated: Apr 30, 2024

CMS has started sending requests for documents from hospitals and providers as they explore No Surprises Act violations. Prepare for your official letters with this article.

Healthcare Policy

Good Faith Estimate Template No Surprises Act: FAQ & Example

Rex H.

Published: Nov 21, 2022

Updated:

We walk you through the official good faith estimate template and outline the requirements you need to know.

Healthcare Policy

No Surprises Act Provider Directory: Requirements for Practices & Plans

Rex H.

Published: Nov 18, 2022

Updated:

Learn what the provider directory is and its requirements in the No Surprises Act for providers and health plans.

Healthcare Policy

No Surprises Act Notice and Consent Form: FAQ & Walkthrough

Rex H.

Published: Nov 14, 2022

Updated:

Get your questions answered in our walkthrough of the No Surprises Act's notice and consent form.

Healthcare Policy

Indiana Price Transparency Laws: House Bills 1004 & 1447

Rex H.

Published: Nov 09, 2022

Updated:

Indiana House Bills 1004 & 1447 augment healthcare price transparency laws established in the No Surprises Act. Learn what the regulations are and how this affects providers in Indiana.

Healthcare Policy

Advanced EOB: No Surprises Act Requirements

Rex H.

Published: Nov 07, 2022

Updated:

The advanced EOB is a new requirement in the No Surprises Act. Learn what must be in this statement and who must get it.

Healthcare Policy

No Surprises Act Final Rule Effective October 25, 2022: New Regulations You Need To Know

Rex H.

Published: Oct 21, 2022

Updated:

Learn the key regulations to know in the No Surprises Act Final Rule that is in effect as of October 25, 2022.

Healthcare Policy

Good Faith Estimate Requirements in the No Surprises Act: All You Need To Know

Rex H.

Published: Oct 17, 2022

Updated:

Good faith estimate requirements are critical to understand to become compliant with the No Surprises Act. Learn all the key regulations to know in our guide.

Healthcare Policy

Patient-Provider Dispute Resolution (PPDR) in the No Surprises Act

Rex H.

Published: Oct 12, 2022

Updated:

Patient-provider dispute resolution is regulated extensively within the No Surprises Act. Learn what the rules are and how PPDR works in this full guide.

Healthcare Policy

No Surprises Act and FQHCs: Why Compliance Is Important

Rex H.

Published: Oct 11, 2022

Updated:

It's critical for FQHCs to comply with the No Surprises Act. Learn why it's important and how good faith estimates and other regulations help FQHCs beyond compliance.

Healthcare Policy

No Surprises Act: Independent Dispute Resolution (IDR) Process

Rex H.

Published: Oct 10, 2022

Updated:

A full guide to the No Surprises Act's federal independent dispute resolution (IDR) process for out-of-network charges.

Healthcare Policy

Convening Provider vs. Co-Facility in the No Surprises Act

Rex H.

Published: Sep 30, 2022

Updated:

Convening providers and co-facilities are treated differently under the No Surprises Act. Learn what the differences are as they pertain to Good Faith Estimates and other regulations.

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