The No Surprises Act protects patients from surprise medical bills for out-of-network emergency treatment. The Act took effect on January 1, 2022. Surprise medical bills occur when insured consumers receive emergency treatment out of network or inadvertently receive out-of-network treatment while at an in-network facility. Previously, consumers could be “balance billed,” meaning being billed more than the in-network sharing cost amount.
The No Surprises Act requires insurance plans to cover all emergency and some non-emergency services provided at out-of-network facilities or by an out-of-network clinician at an in-network facility. Providers and facilities are limited to billing patients the cost-sharing, deductibles, and out-of-pocket maximums the patient would have paid if they received in-network services. Providers are prohibited “balance billing,” i.e., from billing more than the in-network cost-sharing amount (though certain exceptions apply). The No Surprises Act also protects the uninsured and consumers who are paying out of pocket. Providers and facilities must ask about your health insurance coverage before any non-emergency treatment. And in some cases they must provide a good faith estimate of expected charges in clear and understandable language.
We Want to Hear from You
If you believe you may have been balance billed or subjected to a surprise medical bill, you can confidentially contact us by filling out the form on this page.