‘No Surprises Act’ Going Into Effect January 1st

With the new year comes new laws, the ‘No Surprises Act’ which bans most unexpected medical charges from out-of-network providers will go into effect on January 1st. Congress passed the law late last year after multiple delays. It protects patients when they receive emergency care or schedule treatment from doctors and hospitals that are not in their insurance network and that they did not choose. Under the law, patients are responsible only for their in-network cost-sharing. The American Hospital Association, American Medical Association and other providers have filed lawsuits arguing that the Biden Administration’s interpretation of the act unfairly benefits health insurers.

With the new law, consumers may still get big bills they weren’t expecting at the start of the year and will have to satisfy their deductibles before their insurance kicks in even if they see in-network providers. According to the Kaiser Family Foundation, about 1 in 5 emergency room visits and up to 1 in 6 in-network hospitalizations include at least one surprise out-of-network bill. On average patients are hit with over $1,200 for anesthesiologists’ services, $2,600 for surgical assistants and $750 for child-birth related care according to the Department of Health and Human Services.