Compliance Matters Newsletter | August 2023
… ACA), even if those services would otherwise be considered out-of-network. As a reminder, services subject to the prohibition against balance billing are air ambulance claims, emergency services, and services provided by an out-of-network provider at an in-network facility.   Additionally, the FAQs clarify that any contractual arrangement with an air ambulance provider, direct or indirect, makes the air ambulance provider a “participating provider” for purposes of the NSA. Separately, the FAQs indicate that facility fees fall under the definition of “items and services” which are protected under the NSA (and subject to in-network cost-sharing …
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