On Dec. 2, the Centers for Medicare and Medicaid Services (CMS) announced that the agency would continue to postpone enforcement of good faith estimate (GFE) requirements for self-pay or uninsured individuals.
The FAQs, in which CMS announced the postponement, explain that the U.S. Department of Health and Human Services (HHS) is extending enforcement discretion for situations in which GFEs for self-pay or uninsured individuals have no expected charges from coproviders or cofacilities.
According to CMS, HHS received feedback that compliance with the GFE provision would likely not be possible by Jan. 1 because of the technical infrastructure and business practices necessary to implement to meet the provision. CMS notes that any rulemaking to fully implement the GFE requirements related to self-pay or uninsured individuals will also have a prospective applicability date before which providers and facilities will have time to comply with any recently added requirements.
The No Surprises Act included the GFE requirements intended to protect self-pay or uninsured individuals from unexpected high medical bills. Under these requirements, when an item or service is scheduled by a physician or facility, they must determine the patient’s health insurance status. In the case that a patient has no insurance or does not intend to submit a claim to the plan or coverage, the physician or facility is required to notify the patient of the GFE of expected charges.
Source:
https://www.cap.org/advocacy/latest-news-and-practice-data/december-6-2022#story2
