Implementation of the Federal No Surprises Act

TRINIDAD NAVARRO COMMISSIONER STATE OF DELAWARE DEPARTMENT OF INSURANCE TO: RE: DATED: DOMESTIC & FOREIGN INSURERS BULLETIN NO. 127 ALL DOMESTIC AND FOREIGN INSURERS WRITING HEALTH INSURANCE IN DELAWARE IMPLEMENTATION OF THE FEDERAL NO SURPRISES ACT November 30, 2021 The purpose ofthis bulletin is to capture for health care carriers the latest iteration of the Department oflnsurance (the Department's or DOI's) negotiations with the Federal Centers for Medicare and Medicaid Services (CMS) concerning the Department's authority and intention to enforce specified provisions of the Federal No Surprises Act (the NSA). I. Background As referred to in this bulletin, the NSA consists of: • Title XXVII of the Public Health Service Act (PHS Act), as amended by Title I (the No Surprises Act), available at: https://www.govinfo.gov/content/pkg/COMPS- 8798/pdf/COMPS-8798.pclf • Title II (Transparency) of Division BB of the Consolidated Appropriations Act, 2021, available at: https://www.congress.gov/116/bills/hrl33/B1LLS-116hr133enr.pdf: and • The interim final rules implementing certain provisions of the No Surprises Act, including Requirements Related to Surprise Billing Parts I and II: o Part I, published 7 /13, effective 9/13 https://www.federalregister.gov/documents/2021/07 /13/2021- 14379/requirernents-related-to- urprise-billint!:-part-i, and Part II published/effective 11/7: and o Part II, published 10/7, effective 11/7 http ://www.federalregister.e:o /documents/2021/10/07 /2021- 21441/reguirements-related-to-surprise-billing-part-ii The attached table sets forth the Department's current assessment of its jurisdictional authority, noting where determinations are not yet final. Questions concerning this bulletin should be emailed to: DOI-Legal@delaware.gov. This bulletin shall be effective immediately and shall remain in effect unless withdrawn or superseded by subsequent law, regulations, or bulletin. Trinidad Navarro Delaware Insurance Commissioner +INSURANCE.DELAWARE.GOV+ 1351 W. NORTH ST., SUITE 101,DOVER, DELAWARE 19904 (302) 674-7300 DOVER+ (302) 259-7554 GEORGETOWN+ (302) 577-5280 WILMINGTON 3