The Coalition Against Surprise Medical Billing is sharing a four-part blog series to provide a deeper analysis of everything you need to know about the No Surprises Act. The blog series will explain what surprise medical bills are, why the No Surprises Act was passed with broad bipartisan support in Congress, how recent lawsuits are targeting the law, and the role of private-equity.
This first installment of the series provides an understanding of why the No Surprises Act was urgently needed to end the harmful practice of surprise billing, and how the law has already prevented more than 2 million surprise bills in just the first two months of 2022.
Surprise billing, or balance billing, is often referred to when a health care provider bills a patient for the difference between the total cost of services and what is paid by insurance. Oftentimes, the patient receiving the surprise bill is unaware the provider was outside of their network, or they had no choice but to use an out-of-network provider during an emergency. Surprise billing left many patients with unaffordable medical bills and jeopardized the financial wellbeing of many families; but thanks to the No Surprises Act, those days are behind us.
With the law in place, patients can no longer be billed for more than the in-network cost-sharing rate for most out-of-network care. Now, out-of-network care for emergency or scheduled services will not result in financially detrimental billing. And if a patient is seeing an out-of-network provider, the provider is required to notify the patient and obtain written consent. In addition to creating surprise billing protections, eliminating the ability of providers to use surprise bills to their financial advantage encourages more doctors to go in-network and will help reduce premiums across the board.
Not only is the No Surprises Act popular with patients, it had extraordinary bipartisan support in Congress. First signed by President Trump and implemented by President Biden, the protections went into effect on January 1, 2022, with support from Democrats and Republicans alike who wanted American patients to be protected from surprise bills.
The patient protections in the No Surprises Act are an essential step in ensuring that Americans can access health care at a price they can afford. In addition to ending unwarranted surprise bills, the law is also helping combat inflation and rising costs that are burdening far too many Americans.
The No Surprises Act is already providing essential protection from surprise bills. A recent survey from AHIP and the Blue Cross Blue Shield Association (BCBSA) found the legislation prevented 2 million surprise bills in the first two months of 2022, and, if trends hold, it will prevent 12 million surprise bills from reaching the pockets of American patients, this year alone. It is essential the legislation be implemented in full to continue protecting patients and their families from higher health care costs.