The Consolidated Appropriations Act, 2021 (CAA) (Pub. L. No. 116-260) includes provisions to protect health plan enrollees from unexpected out-of-network bills caused by inaccurate provider directories. Beginning in 2022, group health plans, insurance issuers and providers must take specific steps to improve provider directories and bear certain costs when inaccurate directories cause patients to incur out-of-network charges. Although implementing guidance has not come out yet, group health plans and issuers must make a good-faith effort to comply.
This GRIST summarizes the CAA’s provider directory provisions and identifies open issues that may pose compliance challenges. Download the 10-page print-friendly PDF to read the full article.