CMS to Delay Enforcement of a Provision of the No Surprises Act

December 8, 2022

The Centers for Medicare and Medicaid Services (CMS) has announced it is delaying enforcement of a provision of the No Surprises Act set to begin on January 1, 2023.  

The No Surprises Act requires that self-paying and uninsured patients be given a good faith estimate of their medical costs, if requested. The good faith estimate requires that the patient be given an estimate of all applicable costs, including expected charges for any item or service that is reasonably expected to be provided in conjunction with the scheduled or requested item or service. The expected charges include those provided by co-providers or co-facilities. This most commonly occurs in multispecialty scenarios, such as surgical procedures where a surgeon schedules their own time as well as that of other providers who will be involved in the surgery. 

The enforcement of this requirement is being delayed until future rulemaking is issued to allow facilities more time to set up the necessary infrastructure to coordinate with all other facilities/providers when creating the required good faith estimate. 

See additional information from CMS here.