The Baton Rouge (LA) Advocate reports a law ending “health insurance companies’ practice of charging extra for people needing ‘out-of-network’ emergency treatment” took effect on New Year’s Day. “Called the ‘No Surprises Act,’ the new law ends the so-called ‘surprise medical bill’ by forbidding insurers from making a patient pay the difference between what an ‘out of network’ provider or facility charges and what the patient’s insurance plan pays. Insurance companies press their customers to use only those physicians and facilities that have agreed to get paid lower, or in-network, costs for medical services.”
Advocate concerned about impact of “balance billing.” Forbes reports, “The law requires that private health insurance companies cover certain out-of-network bills and apply consumer copayments or other costs as if the care had been delivered by in-network providers.” In addition it “prohibits doctors and hospitals from charging consumers more than they would have to pay for the applicable services if the providers were in-network with the insurance company.” But MedWise Insurance Advocacy founder Adria Goldman Gross warned, “With this new law, my advice is to be sure that you never sign paperwork allowing an out-of-network provider to balance bill you. … You might see hundreds of thousands of dollars billed to you after completion of the surgery [or] procedure.”
American College of Radiology suing federal government over key provision in No Surprises Act.The Radiology Business Journal, “The American College of Radiology is suing the federal government to stop one key aspect of legislation meant to protect patients from surprise medical bills for out-of-network healthcare services.” The group “filed the complaint on Dec. 22 in a Chicago federal district court, joined by the American College of Emergency Physicians,” seeking “to halt a controversial provision in the ‘No Surprises Act’ used to resolve payment disputes between commercial insurers and providers.” Meanwhile, “HHS Secretary Xavier Becerra has defended the administration’s implementation of the law, urging physicians to ‘tighten their belt.’”
Lawmakers push for changes to Surprise Billing Act
Roll Call reports, “All Americans are protected as of Jan. 1 from unexpected out-of-network medical bills, thanks to the implementation of legislation to ban surprise medical billing, but many lawmakers want the Biden administration to make more changes to line up with what they argue was Congress’ intent in crafting the law.” At issue “is who pays for medical care when a patient receives a surprise medical bill, and how to decide how much they owe – an issue that has long divided lawmakers and the health care industry.” Some lawmakers “said HHS’ interpretation of the law deviates from congressional intent when it comes to how payment disputes are settled.”
From the news release of the American Association for Justice.
