Beginning January 1, physicians, hospitals, and air ambulances will no longer be able to “balance bill” patients for certain care outside of their insurance company’s network. 

Surprise billing occurs when a patient receives care from a healthcare provider, often but not always in an emergency situation, outside of the patient’s current health plan network. In other words, the patient may receive a bill from a provider or facility with an amount that is not covered by their insurance because the item or service was outside of their insurer’s provider network.  These bills are also referred to as “balance bills” because the full health plan benefits are not applied to the out-of-network care.

The No Surprises Act prohibits this practice. The No Surprises Act was signed by President Trump in 2020 with bipartisan support. It will be implemented starting January 1, 2022, to ensure that facilities and providers cannot surprise bill for emergency care, for care given by providers that the patient could not choose or did not consent to pay for out-of-network costs, or for out-of-network air ambulance services.

To learn how this new law will impact you and your health insurance benefits, follow us on Facebook by searching @CommissionerDowning or go to the CSI website at CSIMT.gov.”