No Surprises Act: Government Enforcement and Potential Litigation 

Presented by Robinson Bradshaw and PYA

Robinson Bradshaw attorneys Hana Crandall and Travis Hinman provided an overview of the landscape of billing claims against providers in the pre-NSA world, including a discussion of plaintiffs’ typical legal theories in these cases and risks related to class certification. The discussion included the NSA’s requirements and thoughts on future enforcement, potential litigation and areas of risk exposure under the act. The presenters also provided practical observations for compliance and risk mitigation.

PYA principal Martie Ross covered both the payer-provider independent dispute resolution process and the patient-provider selected dispute resolution process, discussing negotiating payment rates for out-of-network services and addressing inaccurate or incomplete good faith estimates of charges.