A recent article from WebMD highlighted the AHIP and Blue Cross Blue Shield Association (BCBSA) survey showcasing the success of the No Surprises Act in protecting patients from out-of-network surprise bills.
When the No Surprises Act took effect in January 2022, those enrolled in private health insurance coverage could no longer be charged above the in-network cost-sharing price by certain out-of-network physicians or hospitals for emergency services. The new survey found that in just two months, the legislation prevented more than 2 million surprise bills from reaching patients and their families. Unfortunately, 8 provider-driven lawsuits seek to dismantle these safeguards and weaken measures designed to decrease health care costs. It is critical the No Surprises Act rules remain in place to ensure no American ever has to face a surprise medical bill that could lead to financial ruin.
Read the full article below:
No Surprises Act Blocked 2 Million Medical Bills in 2 Months: Report
By Carolyn Crist
More than 12 million potential surprise bills could be avoided this year if the trend continues, the study from the Blue Cross Blue Shield Association and America’s Health Insurance Plans found.
“The No Surprises Act ended the practice of surprise medical billing in most circumstances, providing relief for millions of patients who faced surprise medical bills they did not expect at prices they could not afford,” Matt Eyles, president and CEO of America’s Health Insurance Plans, said in a statement.
“Health insurance providers applaud the Administration and Congress for taking this important step,” he said. “But more work needs to be done to ensure a broken bone doesn’t break the bank.”
In December 2020, the No Surprises Act was signed into law, and most of the provisions took effect at the beginning of 2022. Under the law, when anyone covered by private health insurance is treated for emergency services or at an in-network facility by an out-of-network provider, the provider or facility can’t charge a patient above the in-network cost-sharing price.
The law also sets up a way to resolve disagreements on what the health plan will pay the out-of-network provider or facility, which can lead to an independent dispute resolution.
“There is no room for surprise medical bills in a health care system that puts people first,” Kim Keck, the president and CEO of the Blue Cross Blue Shield Association, said in the statement.
“As recently as last year, an emergency visit to the hospital may have left patients on the hook for steep, surprise medical bills,” she said. “The No Surprises Act has not only put an end to this loophole, but it has provided undeniable financial protection to millions of Americans.”
But several hospital and provider organizations have filed lawsuits challenging the No Surprises Act legislation and its rules.
In response, in April 2022, the Blue Cross Blue Shield Association and America’s Health Insurance Plans surveyed their member health insurance plans to gauge the law’s benefits to patients. The survey went to 83 commercial health plans, and 31 plans responded, representing 115 million commercial enrollees, or 54% of the total commercial market.
The survey asked plans to provide their current commercial enrollment and the number of commercial claims they collected and paid in January and February 2022. The survey also asked for the number of claims that were eligible for the No Surprises Act. Based on that, the groups calculated a national estimate.
The survey found that 0.23% of all commercial claims were eligible, adding up to 600,000 claims in January and February. Based on claims data from previous years and factoring in processing delays this year, the insurance groups estimated that the true amount surpassed 2 million surprise bills.
“The estimate may seem rather low, but multiplied by the total number of claims in the commercial market, it yields a substantial number of potential surprise bills that have been avoided,” the groups concluded.