The No Surprises Act (NSA) is designed to protect patients from a variety of healthcare expenses like surprise billing, which allows patients to receive preliminary good faith estimates of care costs. So, what happens when the time comes to enforce the law?
Inaccurate provider directories and compliance failures can be grounds for significant fines. The federal government can issue health plans fines of up to $100 per individual impacted by an NSA violation while providers can also be fined up to $10,000 for compliance errors. Furthermore, each state is authorized to impose their own set of financial penalties for outdated data.
The NSA affects health plans and providers alike. Watch the latest installment of the Madaket Minute to learn more about NSA enforcement and how Madaket can help you stay compliant.
Read the video transcript below and subscribe to Madaket Health on YouTube.
Hello again, everyone, and welcome to another installment of the Madaket Minute. My name is Martin Cody with Madaket Health, and in this Minute, we’re going to talk about the penalties of the No Surprises Act. Now, keep in mind, the No Surprises Act actually is designed to help protect all of us from a variety of different things. And one of it is surprise billing, as we’ve talked about, allowing us to have good faith estimates and knowing in advance what something will cost us to receive that care. But what happens when it doesn’t go according to plan?
For example, let’s say you’re a regional health plan that has 40,000 members, and the information in your member directory is inaccurate. The federal government can fine you up to $100 per individual impacted by those errors. They can also fine providers up to $10,000 for errors. So, if you’ve got 40,000 members, the math becomes pretty compelling to get your data in order. And by the way, that’s just the federal penalties. Each state can also impose their own sets of financial penalties.
Again, the best data is going to win. So, make certain your provider directory is accurate and the data is current.