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What is “The No Surprises Act”?
A law known as the No Surprises Act went into force on January 1, 2022, and it was designed to safeguard consumers against unexpected medical expenditures. These are unforeseen expenses that patients receive from non-participating doctors, non-participating hospitals, or non-participating air ambulance companies. This can occur when a patient receives emergency care from a facility that is not in their insurance network or when a patient receives medical treatment from a provider who is not in their insurance network.
By lowering the cost of out-of-network treatment, the Act seeks to shield consumers from the financial burden of these unforeseen expenses. Consumers will only be liable for the in-network cost-sharing for out-of-network emergency care under the Act. The Act caps consumers’ financial liability for non-emergency treatment at the region’s median in-network charge.
How does this act effect insurers?
The Act also mandates that insurers and providers must offer patients advance notice of their financial responsibilities for out-of-network care as well as clear and accurate information regarding the cost of treatment and the availability of physicians in their network.
It’s vital to remember that the Act only covers specific kinds of insurance plans, such as self-insured group plans and individual plans sold in the fully insured market. Government-funded programs like Medicare and Medicaid are not covered by it.
Consumer Rights, and Obligations
Understand your rights and obligations as a consumer in order to benefit from the protections provided by the Act. New resources have been made available by the Department of Health and Human Services to assist customers in understanding their rights under the Act. Reviewing your insurance policy to determine whether it is protected by the Act is also beneficial. If you do receive an unexpected bill, you should get in touch with your insurance provider and firm to see if you can work something out.
In conclusion, the No Surprises Act is a new piece of legislation that limits patients’ financial liability for out-of-network care in an effort to protect them from unexpected medical expenditures. Additionally, it mandates that healthcare providers and insurers educate patients in advance of their financial obligations and that they receive complete and accurate information about the cost of care. The Act gives consumers certain rights and obligations, and they should be aware of them. They should also use the new instruments at their disposal to learn about their rights and benefit from the Act’s protections.
References
https://www.aha.org/advisory/2021-01-14-detailed-summary-no-surprises-act
https://www.hhs.gov/about/news/2022/01/03/hhs-kicks-off-new-year-with-new-protections-from-surprise-medical-bills.html
