HHS is seeking suggestions on how to regulate the advanced explanation of benefits and cost estimate provisions of the No Surprises Act. While most of the statue took effect in January 2022, regulators announced in August 2021 that these two provisions would be delayed to allow providers and insurers more time to develop the technical infrastructure to carry out these requirements. Under these provisions, the law requires insurers to send beneficiaries explanation of benefits upon request or when items or services are scheduled – at least three days in advance. They must include information about whether providers are in network, whether the items or services are subject to prior authorizations, and how much patients can expect to pay. HHS is accepting comments for a 60-day period, and expects to propose a final rule in, or around January 2023.
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