CONSUMER PROTECTIONS AGAINST SURPRISE BILLING

Starting January 1, 2022, consumers will have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs will be restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network.

 

Currently, if consumers have health coverage and get care from an out-of-network provider, their health plan usually won’t cover the entire out-of-network cost. This could leave them with higher costs than if they’d been seen by an in-network provider. This is especially common in an emergency situation, where consumers might not be able to choose the provider. Even if a consumer goes to an in-network hospital, they might get care from out-of-network providers at that facility.

 

In many cases, prior to the enactmet of the No Surprises Act, the out-of-network provider cold bill consumers for the difference between the charges the provider bills, and the amount paid by the consumer’s health plan. This is known as balance billing. An unexpected balance bill is called a surprise bill.

 

The Consolidated Appropriations Act of 2021 was enacted on December 27, 2020 and contains many provisions to help protect consumers from surprise bills starting in 2022, including the No Surprises Act under title I and Transparency under title II. Learn more here about protections for consumersunderstanding costs in advance to avoid surprise bills, and what happens when payment disagreements arise after receiving medical care. 
 

 

Questions about the no surprise act?

 
 
 
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English
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

 

Vietnamese
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Chinese
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

French
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Gujarati
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Japanese
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Mon-Khmer
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Portuguese - European
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Tagalog
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate

 

Urdu
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Standard Notice and Consent Documents Under the No Surprises Act
Right to Receive a Good Faith Estimate