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).
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.