The No Surprises Act is a federal law that was passed in December 2020 as part of the Consolidated Appropriations Act. The law is designed to protect patients from surprise medical bills, including balance billing, in certain situations. Here are some ways that the No Surprises Act protects patients from balance billing:
- Limiting patient responsibility: The No Surprises Act limits the amount that patients can be held responsible for paying in situations where they receive out-of-network care. Patients are only responsible for their in-network cost-sharing amounts, and cannot be charged more than the in-network cost-sharing for out-of-network emergency care, or for out-of-network care provided at an in-network facility.
- Prohibiting balance billing: Healthcare providers are prohibited from balance billing patients for certain types of out-of-network care, including emergency care, air ambulance services, and certain ancillary services provided at an in-network facility.
- Disclosing network status: The No Surprises Act requires healthcare providers and facilities to disclose their network status to patients, and to provide patients with a good faith estimate of the cost of their care.
- Dispute resolution process: The No Surprises Act establishes a dispute resolution process to resolve payment disputes between healthcare providers and insurers, which should help to reduce the incidence of balance billing.
Overall, the No Surprises Act is designed to protect patients from surprise medical bills, including balance billing, in certain situations. The law limits patient responsibility for out-of-network care, prohibits balance billing in certain situations, requires disclosure of network status and cost estimates, and establishes a dispute resolution process to resolve payment disputes. Do you have concerns or have your received a balance bill? BenefitsDNA has legal resources that can help, contact our team today!
