Recently, the Departments of Labor (DOL), Health and Human Services (HHS), and Treasury/IRS (collectively, the Departments) issued FAQs About the Consolidated Appropriations Act, 2021 Implementation Part 62 (FAQs Part 62) in response to a federal district court ruling in one of the many ongoing legal challenges to the No Surprises Act – Texas Medical Association v. United States Department of Health and Human Services, also known as TMA III – in which the federal district court vacated portions of prior guidance for calculating the QPA. For additional insight and context about the TMA III ruling and FAQs Part 62, please listen to the replays of our September 2023 and October 2023 Regulatory & Compliance Update webinars and read our policy newsletter article.

Next Steps

The IRS guidance provided in Notice 2024-01 is effective January 1, 2024 and should be utilized for calculating the QPA under the No Surprises Act for calendar year 2024. Employer plan sponsors should work with the vendors supporting their IDR administration and calculating QPAs on their behalf to confirm appropriate calculations are in place for 2024.

Legal challenges to various aspects of No Surprises Act implementation, including with respect to the QPA calculation methodology, remain ongoing. The federal government filed notice of appeal to the district court’s ruling in TMA III. Business Group on Health continues to advocate with the Departments on behalf of employer plan sponsors with respect to implementation of the No Surprises Act, and the Business Group and other coalition partners are also engaging key Congressional committees as Congress holds hearings related to surprise billing protections. We will continue to keep members informed of regulatory developments as well as future litigation.

Resources