The No Surprises Act: Protections Against Surprise Medical Bills

Health Cataylst: Surprise Billing in Healthcare: The No Surprises Act Takes a Stand for Patients

The No Surprise Billing Act (NSA) is a new federal law that will take effect in 2022. This law establishes protections against surprise medical bills, which arise when insured consumers receive care from out-of-network hospitals, doctors, or other providers they did not choose. Out-of-network providers don't typically have established contract rates with insurance companies; the No Surprise Billing Act requires them to bill the health insurance first to see if services are covered under the patient's specific plan.

This bill is important because it protects patients from being unexpectedly billed large sums of money for care they did not choose. For example, if you are admitted to the hospital through the emergency room, there's a good chance you will receive care from out-of-network doctors. Under the No Surprise Billing Act, these providers would be required to bill your health insurance first - and you wouldn't be responsible for any unexpected costs.

The provider must bill the health insurance company first to see if services are covered. If they are not, then the provider can bill the patient for any costs not covered by insurance. However, these costs cannot exceed what the insurer would have paid if the service was provided in-network. This provision protects patients from being billed more than they should have to pay for out-of-network care.

The No Surprise Billing Act is an important step towards protecting patients from surprise medical bills, but it's not the only solution. If you have been affected by a surprise bill, please contact your state representative and let them know how this issue has impacted you. Together, we can make sure that no one ever has to pay for the care they didn't choose again.