The Centers for Medicare & Medicaid Services (CMS) on Tuesday released a new report outlining the thousands of complaints the agency has closed related to alleged violations of the No Surprises Act and Affordable Care Act requirements.
As of June 30, 2024, CMS received more than 16,000 complaints, resulting in more than $4 million in restitution to consumers or providers. More than 12,000 of the complaints were related to the No Surprises Act compliance and 248 complaints were regarding Affordable Care Act compliance. There are still more than 3,000 complaints that remain open.
Of the No Surprises Act complaints, 10,300 were made against providers, facilities, and providers of air ambulance services. The most common types of complaints were surprise billing for non-emergency services at an in-network facility, surprise billing for emergency services, and good-faith estimates.
There were an additional 1,777 complaints related to the No Surprises Act made against non-federal governmental plans and issuers. The most common complaints included non-compliance with qualifying payment amount requirement, late payment after independent dispute resolution determination, and non-compliance with 30-day initial payment or notice of denial of payment requirements.