While former President Trump signed the No Surprises Act into law as part of the Consolidated Appropriations Act of 2021, CMS is still working on regulations that will become effective for insured and self-funded health plan years that begin on or after Jan. 1, 2022. Implementing this law will be interesting, experts say. While many of its provisions were designed to protect people from getting unexpected bills for care from out-of-network providers at in-network hospitals and surprise bills from out-of-network emergency care providers including air ambulance services, many types of bills that “surprise” consumers may indeed be outside the scope of the Act.
There are other concerns as well. One of these is a part of the law that requires health plans and out-of-network providers who disagree about charges to seek arbitration. Another is a provision that lets some providers offer care on an out-of-network basis if they advise the patient about potential billing and get a consent form signed. Even though there will be challenges to work through once the law is implemented, policymakers are confident that the No Surprises Act will be a great help to consumers.