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Labcorp: Balance Billing Rights Notice 

This document (the “October 2024 Version”) contains updates for the balance billing rights disclosure required under the No Surprises Act.

  • ·The version sent to Labcorp in January 2024 (the “January 2024 Version”) updated the following:    
    • The main disclosure to reflect version 2 of the “Model Disclosure Notice Regarding Patient Protections Against Surprise Billing” (the “CMS Model Notice”) issued by CMS with the following modifications:
      • Removing reference to “facilities”
      • Referring generally to state-level surprise and balance billing laws
      • Including a disclosure indicating how recently Labcorp updated the state-based disclosures
    • The state-level disclosures based on whether the state had a state-level surprise billing law and to reflect the correct state-level enforcement agency contact information where applicable. Updates to the state-specific content reflect states’ official forms (where found) or were created from official state guidance, website information, statutes, and/or regulations if the state has a state-level surprise and balance billing law with additional protections.
  • The version sent to Labcorp in July 2024 (the “July 2024 Version”) updated the following:
    • Language regarding applicability and enforcement issues in the main disclosure 
    • Statutory and regulatory updates to state-level surprise and balance billing laws that occurred between November 1, 2023, and July 2, 2024
    • Clarifying language
    • Updated hyperlinks in several states
    • Formatting updates
  • The October 2024 Version updates the following:
    • Language in the main disclosure as discussed between EBG and Labcorp on October 15, 2024
    • Substantive updates to New Hampshire to reflect its updated surprise billing law, which will go into effect on January 1, 2025
    • South Carolina regulator contact language
    • State-level balance billing laws for Louisiana and Mississippi. While those states do not have specified state laws, the October 2024 version updates to include disclosure of these laws in case a regulator takes the position that the notice should include such laws.  

 

 

OFFICIAL STATE FORM

Colorado; Idaho; Maryland; New York; Pennsylvania

CMS MODEL NOTICE

Alabama; Arizona; Hawaii; Oklahoma; Rhode Island; Vermont; Wisconsin; Wyoming; North Carolina; Tennessee

CMS MODEL NOTICE + STATE-SPECIFIC ENFORCEMENT CONTACT INFO
  • No state law + State Enforcement + no state model notice: Iowa; South Carolina; West Virginia
  • No state law + Collaborative Enforcement + no state model notice: District of Columbia; Kansas; Vermont; South Dakota
  • No state law + CMS Enforcement + no state model notice. However, official state-specific language was identified: Kentucky; Massachusetts; Missouri; Montana; North Dakota; Utah

DISCLOSURE CREATED

Includes states with state laws where the states DID NOT HAVE MODEL LANGUAGE.

  • Prepared Using Guidance/Official website information: Alaska; California; Connecticut; Michigan; Nebraska; Nevada; New Hampshire; New Jersey; Ohio; Oregon
  • Prepared using statutes/regulations: Arkansas; Delaware; Florida; Georgia; Illinois; Louisiana; Maine; Minnesota; Mississippi; New Mexico; Texas; Indiana

TEMPORARY UPDATES

The following states each have an official state form that has not yet been updated to reflect new laws and/or regulations addressing surprise/balance billing. Updates made in the July 2024 Version reflects these new laws/regulations. However, EBG recommends monitoring for each state’s update to their respective official notice:
  • Colorado’s new state-level balance billing provisions addressing “Transferring Enrollees” will go into effect on January 1, 2025.
  • Virginia’s new state-level balance billing provisions address mental health services.
  • Washington’s new state-level balance billing provisions address ground ambulance services. The enacting statute requires Washington’s regulators to update the state’s official balance billing rights notice.