Since their introduction, the No Surprises Act (NSA) and the Transparency in Coverage (TiC) rule have continued to throw wrench after wrench into the works of the healthcare regulatory landscape. Compliance being a necessity is nothing new, but with the new administration in place, it’s even more critical for all parties involved to stay informed about potential changes to the NSA and TiC rules.
Hot on his second term, President Trump has already set the stage for significant changes in healthcare regulations. The focus we’re currently seeing? Price transparency. A recent Executive Order mandates that hospitals and insurers disclose actual prices for medical services, such as hospital stays and prescription drugs, rather than providing just estimates. This push for transparency means renewed attention and enforcement, which could lead to increased competition among hospitals and insurers. To sum it up, President Trump’s administration is taking bold steps to disrupt the status quo—and we need to be matching those steps with moves of our own.
As the healthcare environment evolves, there are several proactive steps that stakeholders can take to ensure they remain compliant and prepared for whatever changes come next. We’ve put together our recommended key steps to help you prepare for those shifts in our whitepaper. Here’s a brief preview of the highlights!
Key Steps to Prepare for Regulatory Shifts
- Monitor Regulatory Updates and Stay Informed
Healthcare providers and payors must stay on top of regulatory updates, particularly those issued by the Centers for Medicare & Medicaid Services (CMS). Regularly tracking proposed rule changes and administrative interpretations will help organizations anticipate shifts in the landscape and adjust strategies in advance. This can be critical in maintaining compliance and avoiding penalties. - Strengthen Compliance Infrastructure
With transparency requirements ramping up, investing in technology solutions is essential. Insurers should adopt systems that can automate pricing transparency and ensure the timely disclosure of negotiated rates. Advanced solutions can also facilitate compliance with the NSA’s out-of-network billing regulations and streamline the reporting process. - Invest in Employee Education and Training
As regulations around pricing transparency and billing continue to evolve, training staff will be crucial in ensuring compliance. Employees will need to be educated in billing, claims, and patient communication on new requirements related to surprise billing protections, pricing transparency, and dispute resolution. Well-trained teams are less likely to make costly mistakes, helping the organization maintain compliance.
By monitoring regulatory updates and putting in the effort on the front end, organizations can navigate the shifting landscape and remain ahead of the curve. At IPS, we work to stay ahead of that curve through our secure, compliant platforms and our expert team. Explore our deep dive into the NSA and TiC, compliance challenges, and the potential changes the new administration poses by reading our whitepaper today.
