CMS releases No Surprises Act complaint data; CMS reports over 16,000 complaints and $4 million in restitution

The Centers for Medicaid and Medicare Services Aug. 20 released a report presenting data on complaints and enforcement efforts by the agency concerning title XXVII of the Public Health Service Act, which includes both the surprise billing and price transparency provisions of the No Surprises Act. As of June 30, 2024, CMS received more than 16,000 complaints and closed 12,700 with 400 complaints with PHS violations. In total the agency reported over $4 million in restitution for closed cases. Top complaints against plan issuers include non-compliance with Quality Payment Amount requirements, late payment after independent resolution determination, and non-compliance with 30-day initial payment or notice of denial payment requirements. Top complaints against providers relate to surprise bills and good faith estimates.