CMS Issues New  No Surprises Act FAQS on Good Faith Estimates and the Overall Requirements and Exceptions for Healthcare Providers

On April 6, 2022, the Centers for Medicare & Medicaid Services (CMS) issued two new Frequently Asked Questions (FAQs) guidance documents on the requirements of the No Surprises Act (NSA) that addressed a provider’s obligation to provide a Good Faith Estimate for uninsured and self-pay patients, and certain NSA requirements and exceptions.  CMS also announced plans to launch an online portal through which uninsured and self-pay patients may initiate the Independent Dispute Resolution Process.

The New FAQs on the obligation to provide a Good Faith Estimate (GFE) addressed several questions by healthcare providers including whether the following must be included or addressed in a GFE: diagnosis codes, expected charges for future visits, reoccurring items or services, unforeseen items or services, and when a provider is required to provide a GFE to uninsured or self-pay individuals.

CMS also issued a new FAQ for providers regarding several requirements of the NSA, including:  exceptions for when the NSA is applicable, certain non-emergency services by out-of-network providers for patient visits at in-network facilities, required patient disclosures, and continuity of care situations when a provider’s network status changes.

These two FAQS are available at:

New FAQ on the Good Faith Estimate requirements:

New FAQ on the overall NSA requirements:

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