Goodbye Unexpected Medical Bills: No Surprises Act Hits in 2022

At the dentist office, medical.
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The No Surprises Act, which is putting an end to surprise medical bills from out-of-network providers, is scheduled to go into effect on Jan. 1, 2022. According to federal estimates, it will apply to 10 million unexpected bills per year, CNN reports.

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Beginning New Year’s Day, it will be illegal for providers to charge patients excessive out-of-pocket costs for treatments the patient did not choose. Emergency services must also continue to be covered without any prior authorization, regardless of whether or not a provider or facility is in-network. In these situations, consumers are responsible for their in-network deductibles, copays or coinsurance, CNN mentioned.

Surprise medical bills typically arise when insured patients receive emergency care, non-emergency care from out-of-network providers at in-network facilities and air ambulance services from out-of-network providers, according to the U.S. Centers for Medicare & Medicaid Services.

“The No Surprises Act is really one of the biggest consumer protections to pass in recent decades,” Loren Adler, assistant director of the USC-Brookings Schaeffer Initiative for Health Policy, explained to CNN. “Now when patients go to the hospital for an emergency or for elective planned care, like a surgery, they no longer have to worry about getting a surprise out-of-network bill.”

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The new law will apply to almost all private health plans offered by employers and to individual policies bought on or off the Affordable Care Act exchanges, CNN noted. If a patient chooses to see an out-of-network provider, the provider is required to give notice of their network status as well as estimates of charges. The patient must also give consent to receive out-of-network care that could cost them more.

CNN added that this act is expected to reduce premiums by 0.5% to 1%, in most markets in most years, according to data from the Congressional Budget Office.

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About the Author

Josephine Nesbit is a freelance writer specializing in real estate and personal finance. She grew up in New England but is now based out of Ohio where she attended The Ohio State University and lives with her two toddlers and fiancé. Her work has appeared in print and online publications such as Fox Business and Scotsman Guide.

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