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No Surprises Act notices: What happens if there's no public-facing website?


The requirement for the No Surprises Act notice is for group health plans to make a notice publicly available by posting to the health plan’s public website and include it on each EOB when it applies to the balance billing rules. Q/A #11 of FAQs Part 55 confirms that if the employer has a public website, but there is no website for the health plan, the disclosure requirement can be met by entering into a written agreement with the carrier or TPA to post it publicly on behalf of the plan. However, even if there is a written agreement, if the carrier or TPA fails to post the required disclosure, the plan violates the disclosure requirements. Plans and issuers are also required to provide applicable state law balance billing protection notices, which would primarily impact fully-insured plans in certain states. An updated model notice to be used starting in 2022 and beyond provided by CMS can be found here: https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf


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