CMS Delays No Surprises Act Good Faith Estimate Requirements for Co-Providers

In December, CMS issued an FAQ, delaying the requirement that the good faith estimate include cost estimates from co-providers and co-facilities starting January 1, 2023, as outlined in the No Surprises Act. 

Q1: Will CMS enforce the requirement that GFEs for uninsured (or self-pay) individuals include cost estimates from co-providers and co-facilities beginning on January 1, 2023?

A1: No. HHS is extending enforcement discretion, pending future rulemaking, for situations where GFEs for uninsured (or self-pay) individuals do not include expected charges from co-providers or co-facilities.

On page 2, CMS clarified, “HHS has received comments and feedback indicating that compliance with this provision is likely not possible by January 1, 2023, given the complexities involved with developing the technical infrastructure and business practices necessary for convening providers and facilities to exchange GFE data with co-providers and co-facilities. Stakeholders have requested that HHS further delay the enforcement of this provision until HHS has established a standard technology or transaction to automate the creation of comprehensive GFEs and given providers and facilities sufficient time to implement such standards.”

For additional information on the good faith estimate, visit the XiFin No Surprises Act Resource Center.

Source: https://www.cms.gov/files/document/good-faith-estimate-uninsured-self-pay-part-3.pdf