Departments of HHS, Labor, and Treasury Release FAQs on Transparency, No Surprises Act Regulations

AHA Special Bulletin
August 23, 2021

Sign In to Download the Special Bulletin PDF

The Departments of Health and Human Services, Labor, and Treasury (“the departments”) Aug. 20 released a set of Frequently Asked Questions (FAQs) related to provisions in the No Surprises Act and the Transparency in Coverage final rule. As requested several times by the AHA, the departments announced they will be deferring enforcement of the good faith estimate requirements for insured patients, as well as the advanced explanation of benefit requirement. They also recognize the significant overlap between several of the No Surprises Act provisions and the transparency in coverage final regulations and plan to streamline requirements where appropriate. Finally, they identified several instances where they do not expect to issue regulations before a provision’s effective date, and addressed how they will monitor enforcement in those cases.

AHA Take

The AHA supports the departments’ decision to delay enforcement of the good faith estimates for insured patients. We appreciate that the departments listened to our concerns on the significant operational issues with this requirement, and we look forward to working with them and other stakeholders to implement these provisions, including through the development of appropriate technical standards.

Highlights from the FAQs follow.

Key Takeaways

  • The departments will defer enforcement of the No Surprises Act good faith estimates for insured patients and advanced explanation of benefit requirements.
  • Providers and facilities will still be required to generate good faith estimates for the uninsured.
  • The departments will delay enforcement of the insurer machine-readable files, required in the transparency in coverage final rule, until July 1, 2022.

Related Resources

Special Bulletin
The Departments of Health and Human Services (HHS), Labor, and Treasury and the Office of Personnel Management (“the departments”) Sept. 10 released proposed…
Fact Sheets
The No Surprises Act established new patient protections against balance billing in certain circumstances, as well as put into place a number of other…
Special Bulletin
The AHA today released a new episode of PowerPlay, the on-demand video series that connects AHA members to major players in policy, politics and science. The…
Laurie Bodenheimer                                      Ali…
Special Bulletin
The AHA submits comments to the Departments of Health and Human Services, Labor and Treasury, as well as the Office of Personnel Management, on the first…
AHA Center for Health Innovation Market Scan
Hoping to prevent patients from delaying or not getting needed care, Pennsylvania-based Geisinger has introduced a customizable zero-interest artificial…