The No Surprises Act Is Now In Full Effect


Happy New Year! On behalf of everyone at Allegiant Experts, we wish you a very happy and safe 2022. We’re especially glad to announce that, as of January 1st, the No Surprises Act is in full effect. Our blog has been reporting on this happening over the past year. The new legislation was passed and signed into law by Congress back on December 27, 2020. Now that it has been enacted, patients all over the United States will be protected from surprise medical bills.


Prior to the enactment of the No Surprises Act, people could receive surprise medical bills if they received care from either out-of-network providers or out-of-network facilities. Even if they were incapacitated and didn’t even realize they were receiving the care, substantially-large bills could arrive in the mail to cover their care at some point later. People with Medicare and Medicaid are generally protected from these surprise bills.


What are the new protections for people with health insurance?


As reported by the Centers for Medicare & Medicaid Services, the No Surprises Act helps individuals who have their own health insurance plans. The coverage can be attained through an employer or independently from an insurance company. With the new rules in place, surprise bills for most emergency services are banned. The new law also bans out-of-network cost-sharing (such as out-of-network coinsurance or copayments) for most emergency and some non-emergency services.


As well, banned are out-of-network charges and balance bills for certain additional services. These include anesthesiology or radiology and those furnished by out-of-network providers as part of a patient’s visit to an in-network facility. In addition, the No Surprises Act requires that health care providers and facilities give patients easy-to-understand notices. They must explain the applicable billing protections and who to contact about concerns.


What are the new protections for people without health insurance?


“If you don’t have insurance or you self-pay for care, in most cases, these new rules make sure you can get a good faith estimate of how much your care will cost before you receive it,” reports CMS. They also inform about the protections for those who are charged more than their good faith estimates. For any services provided in 2022, a person can dispute a medical bill if the final charges are at least $400 higher than the good faith estimate. Dispute claims must be filed within 120 days of the date on the bill.


“Some health insurance coverage programs already have protections against surprise medical bills,” confirms CMS, “If you have coverage through Medicare, Medicaid, or TRICARE, or receive care through the Indian Health Services or Veterans Health Administration, you don’t need to worry because you’re already protected against surprise medical bills from providers and facilities that participate in these programs.”


Where can you learn more about the No Surprises Act?


If you have any questions, you are encouraged to visit CMS.gov/nosurprises. You may also call the Help Desk at 1-800-985-3059 for more information. TTY users can call 1-800-985-3059. To get in touch with Allegiant Experts to learn all about our health care consultancy, please don’t hesitate to call us at 407-217-5831 or email us at info@allegiantexperts.com.

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