Sunday, September 25, 2022

The law protecting patients from sudden medical bills is starting from January 1

Patients with health insurance from emergency visits and other out-of-network health care services starting in January will no longer receive as many unexpected medical charges.

Running news: No wonder the Act will take effect from January 1, 2022, and patients will only be required to pay in-network cost-sharing amounts in those situations.

  • Patients will still be responsible for things like co-insurance payments and deductibles. But sudden out-of-network charges, which are extraordinarily common, will be effectively banned.
  • The law was approved by Congress in late 2020 and gets rid of surprise medical billing, which occurs when a person receives medical care by a provider outside of their private insurer’s network, even if traveling in-network. be at the facility.
  • Any outstanding charges will have to be settled between health insurers and out-of-network medical providers.
  • Ground ambulances can still bill patients separately but the law provides protection against surprise billing from air medical transport.
  • According to the Center for Medicare and Medicaid Services, the new law applies to nearly all private health insurance plans offered by employers (including federal, state or local government).
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By numbers: The Kaiser Family Foundation says that patients receive sudden bills in about 1 in 5 emergency room visits.

  • Additionally, 9% of in-network hospitalizations for non-emergency care and 16% of in-network hospitalizations included astonishing bills from out-of-network providers that the patient did not choose, like an anesthesiologist, per KFF.
  • Citing a report from the Department of Health and Human Services, patients can be charged more than $1,200 for anesthesiologists’ services, $2,600 for surgical assistants, and $750 for care related to childbirth.

What are they saying: HHS Secretary Javier Becerra said during the summer, “No patient should seek care for fear of surprising billing.”

  • “Health insurance should provide patients with peace of mind that they will not be saddled with unexpected costs … and with this rule in place, Americans will be assured of no surprises,” he said.
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