On December 30th, 2021 the No Surprises Act went into effect. Broadly speaking, the act aims to curb surprise bills Americans may incur when they receive care from an out-out-network provider.  

In response to the act’s implementation, the American Hospital Association, American Medical Association, and others sued, claiming the law jeopardizes patients’ access to care on the basis that providers and insurers must negotiate these costs when they arise, and if an agreement is not made, an arbitration process for determining fair payment will take place.

On this episode of Managed Care Cast, we speak with Mark Miller, PhD, the executive vice president of health care at Arnold Ventures. In our conversation, Miller lays out how this law came about, its implications for patients, and what might happen if lawsuits against it succeed.

Understanding Surprise Billing in the US & How the No Surprises Act Aims to Curb It

Science

On this episode of Managed Care Cast, we're talking with Illinois CancerCare's Pankaj Kumar, MD, and Stephanie Parker, PharmD, 2 authors of a commentary published in the May 2024 issue of The American Journal of Managed Care.

Their commentary, "Access Denied: CMS’ Action Hurts Patients With Cancer in Rural America," discusses how recent CMS rules restricted the access of rural patients with cancer to medically integrated pharmacies, emphasizing the need for regulatory change.

Cancer Care Crisis: Experts Discuss CMS Restrictions Impacting Rural Patients With Cancer

In the series debut episode of Frameworks for Advancing Health Equity, Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.

Frameworks for Advancing Health Equity: Urban Health Outreach

On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega. We discussed CMS's recent Medicare Part D and Medicare Advantage final rule and how it affects enrollees and health plans.

CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection

To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.

Tackling Health Inequality: The Power of Education and Experience

On this episode of Managed Care Cast, we're talking with the University of Pennsylvania's Ravi Parikh, MD, MPP, and Aaron Schwartz, MD, PhD, 2 authors of a study published in the April 2024 issue of The American Journal of Managed Care®.

Their study, "Trends in Low-Value Cancer Care During the COVID-19 Pandemic," discusses how rates of low-value cancer services among adults with newly diagnosed cancer persisted throughout the COVID-19 pandemic.

Understanding Surprise Billing in the US & How the No Surprises Act Aims to Curb It

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