‘No Surprise Act,’ which will seek to protect patients from surprise medical bills, takes effect nationwide

Starting January 1st, 2022 the “No Surprise Act” goes into effect, which would protect patients from unknowingly receiving medical care outside of insurance coverage.

Passed with bipartisan support in Congress and signed by then-President Donald Trump, the No Surprises Act (NSA) protects consumers against so-called “surprise” medical bills.

Surprise billing occurs when a patient has no knowledge or opportunity to choose care from a provider inside of the patient’s health plan network. According to CNBC, the new rules will apply to private insurers and those through the Affordable Care Act.

Patricia Kelmar, a director of health care campaigns at U.S PIRG says, “It takes advantage of people at their most vulnerable moment. It’s not like you’re given a bunch of offers of who you can choose as a provider. The last thing you’re doing at that point is checking network status and asking for cost estimates.”

Once the act goes into effect, you will not receive a surprise bill from an out-of-network provider when you receive emergency care in an emergency room, receive care at an in-network healthcare facility, or when you are transported by an air ambulance. The consumer will no longer be put in the middle of the provider and insurer, as they will only be responsible for in-network costs.

As a result, insurance companies or providers will be responsible for outstanding costs. These new protections will only apply to hospitals, emergency departments, and places that provide emergency services.

Additionally, it does not cover ground ambulance transportation or non-emergency services, or non-emergency services provided in other clinics or facilities. To avoid any out of network costs, it is advised to specifically ask your provider if they are part of your plan’s network.