CMS has directed that over $4 million in monetary relief be paid to consumers or providers.
August 23, 2024 – Susan Morse, Executive Editor –
The Centers for Medicaid and Medicare Services this week released a report on complaints and enforcement efforts concerning the Public Health Service Act, which includes the No Surprises Act.
As of June 30, CMS received more than 16,073 complaints. Of these, 12,077 were No Surprises Act complaints, with 1,777 being alleged violations against insurers and 10,300 against hospitals, other providers and air ambulance services.
The CMS Complaints Data and Enforcement Report has closed 12,700 complaints.
Through the CMS investigation process, CMS has directed plans, issuers, providers, healthcare facilities, or providers of air ambulance services to take remedial and corrective actions to address instances of non-compliance, which has resulted in approximately $4,183,383 in monetary relief paid to consumers or providers.
WHY THIS MATTERS
The three most common complaints against providers, including air ambulance services were: Surprise billing for non-emergency services at an in-network facility (4,286); surprise billing for emergency services (2,577); and good faith estimates (1,922).
