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- ICYMI - CMS Delayed Enforcement of GFE Requirements
Earlier in December, the Centers for Medicare & Medicaid Services (CMS) announced it delayed the enforcement of the good faith estimate (GFE) requirements for uninsured and self-pay individuals. The CMS released a FAQ stating that the Department of Health and Human Services (HHS) extended enforcement discretion, pending future rulemaking, for situations where GFEs for uninsured (or self-pay) individuals do not include expected charges from co-providers or co-facilities.
The GFE requirements were included in the No Surprises Act and intended to protect uninsured (or self-pay) individuals from unexpectedly high medical bills. When a physician/facility schedules an item or service (such as a medical device, a doctor’s visit, or a surgical procedure), it must determine the individual’s health insurance status. If the patient has no coverage (uninsured) or does not intend to submit a claim to the plan/coverage (self-pay), the physician/facility must provide notification to the patient of the good faith estimate of expected charges.
Check out the FAQs for more information.