By Jack Hoadley, Kevin Lucia, and Beth Fuchs
On December 22, Congress enacted a $900 billion COVID-19 relief and government spending bill that included comprehensive bipartisan, bicameral legislation to protect consumers from surprise medical bills, called the No Surprises Act. Federal legislation has been under consideration for more than a year, but prior efforts were stymied, in part because of intense lobbying by private-equity-backed interests, even as the need for comprehensive patient protections was made more urgent by the pandemic.
The new legislation, effective in 2022, will protect consumers from surprise bills for: 1) emergency services delivered by out-of-network providers, including emergency air transport, or by out-of-network facilities; and 2) nonemergency services provided by out-of-network providers in network facilities and for which patients do not consent. Consumers’ costs will be limited to cost-sharing amounts that apply to in-network services; providers are banned from billing for any higher amounts.
In their latest To the Point post for the Commonwealth Fund, CHIR experts review the major provisions of the bill and what they mean for patients. You can read the full post here.