Surprise Billing - Good Faith Estimates

On January 1, 2022, a new surprise billing rule for health care providers will go into effect. read on to learn more about what this rule means for community health centers.
On September 30, the U.S. Department of Health and Human Services (HHS) released an Interim Final Rule (IFR) to implement portions of a surprise billing proposal, passed by Congress in December of 2020. 
What does the Interim Final Rule require of providers? 
The Interim Final Rule requires health care providers, including community health centers, to provide uninsured and self-pay patients with a ‘Good Faith Estimate' of their costs if the patient schedules the service at least 3 business days in advance, or requests information about charges. 
Community health centers must include diagnosis codes and the exact charges for the primary service that will be provided to the patient, along with other items or services that are separately charged in the course of the primary service. 
How do health centers protect patients from surprise medical bills?
The unique structure of community health centers already ensures patients are protected from unaffordable medical bills. By mission and statute, health centers provide high-quality primary care to all patients that come through their doors regardless of their health insurance status or ability to pay for care. In Tennessee, 69% of health center patients have incomes below the Federal Poverty Level and 31% are uninsured.1
Community health centers provide affordable services to low-income and uninsured patients using a sliding fee scale based on patients' incomes. Health centers also rely on specialized staff to assist patients through the process of obtaining health insurance if they are uninsured and walk patients through the sliding fee discount scale. 
How would the Good Faith Estimate Rule affect health centers?
The Good Faith Estimate Rule isn't compatible with how community health centers operate. In a time when health centers are serving on the front lines of the COVID-19 pandemic, it would be challenging for health centers to implement a new rule that increases administrative burden without providing additional benefits to health center patients.
HHS accepted public comments on the Interim Final Rule through December 6, 2021, and may take comments into consideration when making adjustments to the rule. However, the rule is still set to go into effect on January 1, 2022.
[1] Tennessee Health Center Program Uniform Data System (UDS) Data. (2021). Retrieved from



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