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January 06, 2023

No Surprises Act News

In No Surprises Act news, the Labor Department’s Employee Benefit Administration Announced on December 23, 2022:

  • Effective January 1, 2023, the administrative cost for holding an arbitration under an independent dispute resolution process will increase from $50 per party to $350 per party. That should tamp down the number of NSA arbitrations. 
  • ACA FAQs 56 concerning the NSA prescription drug reporting that health plans, including FEHB plans, are scheduled to submit next Tuesday, December 27, for the 2020 and 2021 plan years. Significantly: 

For the 2020 and 2021 data submissions that are due by December 27, 2022, the Departments will not take enforcement action with respect to any plan or issuer that uses a good faith, reasonable interpretation of the regulations and the Prescription Drug Data Collection (RxDC) Reporting Instructions in making its submission. The Departments are also providing a submission grace period through January 31, 2023, and will not consider a plan or issuer to be out of compliance with these requirements provided that a good faith submission of 2020 and 2021 data is made on or before that date.

  • Initial Report on the Independent Dispute Resolution Process: April 15 – September 30, 2022. The report indicates that the arbitrators are swamped with cases. 

In Affordable Care Act news, on December 12, 2022, the Department of Health and Human Services announced the premium adjustment percentage, maximum annual limitation on cost sharing, reduced maximum annual limitation on cost sharing, and required contribution percentage (payment parameters) for the 2024 benefit year. 

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