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No Surprise Act

 The No Surprise Act 2022 (NSA) establishes new federal protections against surprise medical bills that take effect in 2022. 



What is No Surprise Act:

NSAs occur when insured people are treated by out-of-network hospitals, doctors, or other providers they did not choose. This occurs in around one out of every five visits to the emergency room. In addition, surprise expenditures from out-of-network doctors (such as anesthesiologists) whom the patient did not choose an account for 9 to 16 percent of in-network hospitalizations for non-emergency care. Consumers suffer unexpected medical expenditures when health plans decline out-of-network claims or impose greater out-of-network cost-sharing; consumers also face "balance billing" from out-of-network providers who have not agreed to accept the health plan's discounted payment rates. The NSA is expected to apply to around 10 million out-of-network unexpected medical expenses per year, according to the federal government. The NSA will protect consumers from surprise medical bills by:

·        requiring private health plans to cover these out-of-network claims and apply in-network cost-sharing. The law applies to both job-based and non-group plans, including grandfathered plans

·        prohibiting doctors, hospitals, and other covered providers from billing patients more than in-network cost-sharing amount for surprise medical bills.

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  1. Medical bill codingApril 12, 2022 at 3:25 AM

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